SPLENIC EXTRAMEDULLARY HEMATOPOIESIS IN A PATIENT RECEIVING INTERMITTENTLY ADMINISTERED GRANULOCYTE-COLONY-STIMULATING FACTOR

A 22-year-old man received four cycles of cyclophosphamide, vincristin e, doxorubicin, prednisone, and etoposide with intermittent granulocyt e colony-stimulating factor (G-CSF) for the treatment of a high-grade, stage I malignant lymphoma involving the axilla. On re-evaluation, th e axillary mass had completely disappeared: however, splenomegaly was present and lactate dehydrogenase levels were elevated 3 weeks after h is final chemotherapy and G-CSF treatments. Because refractory disease was a concern, splenectomy was done. Spleen sections showed extramedu llary hematopoiesis but no lymphomatous involvement. To our knowledge, we report the first case of splenomegaly with extramedullary hematopo iesis in a patient receiving intermittent G-CSF therapy. Clinicians sh ould be aware that splenomegaly occurring in this setting does not nec essarily indicate refractory lymphoma.