Patrick P. Litam, MD; Henry D. Friedman, MD; Thomas P. Loughran Jr., MD
A 22-year-old man received four cycles of cyclophosphamide, vincristine, doxorubicin, prednisone, and etoposide with intermittent granulocyte colonystimulating factor (G-CSF) for the treatment of a high-grade, stage I malignant lymphoma involving the axilla. On re-evaluation, the axillary mass had completely disappeared; however, splenomegaly was present and lactate dehydrogenase levels were elevated 3 weeks after his final chemotherapy and G-CSF treatments. Because refractory disease was a concern, splenectomy was done. Spleen sections showed extramedullary hematopoiesis but no lymphomatous involvement. To our knowledge, we report the first case of splenomegaly with extramedullary hematopoiesis in a patient receiving intermittent G-CSF therapy. Clinicians should be aware that splenomegaly occurring in this setting does not necessarily indicate refractory lymphoma.
Litam PP, Friedman HD, Loughran TP. Splenic Extramedullary Hematopoiesis in a Patient Receiving Intermittently Administered Granulocyte ColonyStimulating Factor. Ann Intern Med. ;118:954–955. doi: 10.7326/0003-4819-118-12-199306150-00007
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Published: Ann Intern Med. 1993;118(12):954-955.
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