An autopsy case of primary malignant lymphoma of the spleen with acute liver failure and respiratory failure

Abstract

A woman in her late 70s had complained of somnolence and difficulty moving. She had been found to have impaired liver function accompanied by disturbance of consciousness at another hospital, and was transferred to our hospital for treatment of hepatorenal dysfunction with disseminated intravascular coagulation. Abdominal ultrasonography and computed tomography showed significant splenomegaly and a low-density area of 13 mm in diameter in the spleen. Despite multidisciplinary treatment being initiated immediately, in addition to the liver and renal failure, respiratory failure due to bilateral diffuse alveolar hemorrhage occurred on the third day of hospitalization, so the patient was placed on ventilatory management. We could not determine the cause of these events during her clinical course, and she unfortunately died on the 17th day of hospitalization. Pathological autopsy finally led to the diagnosis of primary malignant lymphoma of the spleen (diffuse large B-cell lymphoma) with hepatic and pulmonary invasion.