THE RELATIONSHIP BETWEEN PRIMARY SPLENIC MALIGNANT-LYMPHOMA AND CHRONIC LIVER-DISEASE ASSOCIATED WITH HEPATITIS-C VIRUS-INFECTION

BACKGROUND, An etiologically important role has been suggested for hep atitis C virus (HCV) infection in the development of B-cell non-Hodgki n's lymphoma (NHL). HCV has been recognized as the major cause of non- A, non-B chronic hepatitis throughout the world. Moreover, the occurre nce of primary splenic malignant lymphoma (PSML) has been demonstrated in patients with chronic liver disease.METHODS. In this study, the au thors describe three patients with PSML. The clinical, histologic, and immunohistochemical features of the lymphomas were studied. Clonal im munoglobulin heavy chain gene rearrangement was investigated by polyme rase chain reaction. RESULTS. All three cases of PSML were detected by imaging studies performed in routine follow-up of cases of chronic li ver disease associated with HCV infection. Macronodular lesions were f ound in the three spleens; two of them were of normal weight and anoth er was moderately enlarged. The former two were the smallest PSMLs rep orted to date. The histology was B-cell NHL in all cases. All 3 patien ts were alive after splenectomy with an average follow-up of 51.7 mont hs (range, 35-74 months). CONCLUSIONS, HCV infection may play an etiol ogic role in the development of splenic B-cell lymphoma The long survi val of the patients in this study may have been due to early splenecto my. (C) 1997 American Cancer Society.