T-Cell–Rich B-Cell Lymphoma Presenting as Splenic-Dominant Disease Mimicking Malignancy of Unknown Origin: A Case Report
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- 1. International Journal of Medical Science and Innovative Research (IJMSIR)
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Abstract
T-cell–rich B-cell lymphoma (TCRBCL) is a rare variant of diffuse large B-cell lymphoma that often presents at an advanced stage and poses significant diagnostic challenges. We report a case of a 69-year-old male who presented with splenomegaly and multiple hypodense splenic lesions on contrast-enhanced computed tomography, along with borderline abdominal lymphadenopathy and gastric antral wall thickening, initially raising suspicion of malignancy of unknown origin. Upper gastrointestinal endoscopy was normal, and splenic biopsy was not feasible due to bleeding risk. Whole-body ¹⁸F-FDG PET-CT revealed widespread FDG-avid nodal disease, splenic lesions, and extensive bone marrow involvement. Definitive diagnosis was established by excision biopsy of cervical lymphadenopathy, confirming T-cell–rich B-cell lymphoma. The patient was treated with standard R-CHOP chemotherapy and showed good clinical response. This case highlights the diagnostic dilemma of splenic-dominant disease and emphasizes the role of PET-CT and safe nodal biopsy in establishing the diagnosis.
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References
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