Clinical benefit of R-CHOP without splenectomy in stage I primary splenic diffuse large B-cell lymphoma

BMJ Case Rep. 2022 Jan 4;15(1):e246610. doi: 10.1136/bcr-2021-246610.


Primary splenic diffuse large B-cell lymphoma (PS-DLBCL) is a relatively rare malignancy, and there are no optimal approaches for diagnosis and management. There are less invasive splenic biopsies that effectively obviate diagnostic and elective splenectomies. We report a man in his 50s with 2-day history of pain in the abdomen and who was found to have a splenic mass on PET-CT. A CT-guided core needle splenic biopsy confirmed the diagnosis of PS-DLBCL. He was managed with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) alone, without splenectomy. The patient attained complete remission, and he is disease free at 6 years of follow-up.

Keywords: cancer intervention; chemotherapy; haematology (incl blood transfusion); malignant and benign haematology; oncology.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / surgery
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Prednisone / therapeutic use
  • Rituximab / therapeutic use
  • Splenectomy*
  • Vincristine / therapeutic use


  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone