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Affiliation |
Hospital Center for Medical Education and Training |
KOBAYASHI Isuzu
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Graduating School 【 display / non-display 】
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-2009.03
Akita University Faculty of Medicine Graduated
Graduate School 【 display / non-display 】
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-2016.03
Akita University Graduate School, Division of Medicine Doctor's Course Completed
Campus Career 【 display / non-display 】
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2022.09-Now
Akita University Hospital Center for Medical Education and Training Specially-appointed Assistant Professor
Research Areas 【 display / non-display 】
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Life Science / Hematology and medical oncology
Research Achievements 【 display / non-display 】
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Postmortem diagnosis of intravascular large B-cell lymphoma after atraumatic splenic rupture due to splenic infiltration
KUROKI Wataru, KOBAYASHI Takahiro, UMAKOSHI Michinobu, KITADATE Akihiro, IMAIZUMI Chihiro, SAITO Masaya, KOBAYASHI Isuzu, FUJISHIMA Masumi, FUJISHIMA Naohito, YOSHIOKA Tomoko, GOTO Akiteru, TAKAHASHI Naoto
Rinsho Ketsueki ( The Japanese Society of Hematology ) 63 ( 6 ) 523 - 529 2022
<p>Atraumatic splenic rupture (ASR) is a rare but fatal complication of malignant lymphoma. However, only one case of intravascular large B-cell lymphoma (IVLBCL)-related ASR (IVLBCL-ASR) has previously been reported, and the mechanism of IVLBCL-ASR is unknown. We present the case of a 78-year-old man who died unexpectedly and was diagnosed with IVLBCL-ASR pathologically by autopsy. A massive intraperitoneal hemorrhage and four lacerations on the splenic surface were discovered during the autopsy. CD20-positive lymphoma cells that infiltrated into small vessels were highly concentrated in the center of the spleen and were only slightly distributed in the lacerations on the splenic surface. Therefore, increased intrasplenic pressure due to lymphoma cell proliferation was identified as the cause of ASR. The patient had undergone <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT) for tongue cancer evaluation 3 months earlier, and positive uptake was found in the right adrenal gland, where lymphoma cell infiltration was confirmed by the autopsy. Our findings suggest that clinicians should be aware that the advanced stage of IVLBCL can cause fatal ASR via increased intrasplenic pressure. Therefore, early diagnosis and early treatment intervention are desirable to prevent the onset of IVLBCL-ASR, and <sup>18</sup>F-FDG PET/CT is useful for the early diagnosis of IVLBCL.</p>