Fever of unknown origin revealed to be primary splenic lymphoma: A rare case report with review of the literature
- Pan‑Ge Sun
- Bei Cheng
- Jin‑Feng Wang
- Ping He
Published online on: Wednesday, December 14, 2016
Fever is a common clinical presentation of a number of diseases. A sustained unexplained fever >38.3˚C lasting for >3 weeks without an established diagnosis despite intensive diagnostic evaluation is referred to as fever of unknown origin (FUO). FUO remains a clinical challenge for physicians, as it may be attributed to a wide range of disorders, mainly infections, malignancies, non‑infectious inflammatory diseases and miscellaneous diseases. We herein report the case of a 59‑year‑old male patient who presented with prolonged unexplained fever and was found to have a diffusely enlarged hypermetabolic spleen, as shown on 18F‑fluorodeoxyglucose positron emission tomography/computed tomography examination. Following splenectomy, histopathological examination revealed primary splenic lymphoma (PSL) of B‑cell origin. The patient received 6 courses of systemic chemotherapy with rituximab, etoposide, cyclophosphamide, doxorubicin, vincristine and prednisone (R‑ECHOP regimen) and responded well to treatment. Thus, in patients with FUO and splenomegaly, the possibility of PSL should be taken into consideration.