Two rare cases of primary splenic lymphoma with diffuse large B-cell and small B-cell type: an Indonesian report

Primary splenic lymphoma (PSL) is a very rare form of lymphoma accounting for <2% of all lymphomas and <1% of all non-Hodgkin lymphoma (NHL) cases, respectively. The type of NHL in PSL is diffuse large B-cell lymphoma (DLBCL) which is the most common type, with the rest being the small B-cell (SBL) type. PSL is defined as a lymphoma that occurs only in the spleen and cannot be found in lymph nodes, even though the staging of cases includes enlargement of the regional lymph nodes around the spleen. Diagnosis and treatment for PSL are quite challenging, considering the case is still uncommon. We report two rare cases of PSL based on the history taking, physical examination, radiological imaging, histopathology, and immunohistochemistry. The first case was a 45-year-old female diagnosed with DLBCL-type PSL who had a splenectomy following a full cycle of chemotherapy. The second case was a 52-year-old male with a diagnosis of SBL-type PSL who only had a splenectomy without receiving chemotherapy. Although they had quite similar clinical presentations, both cases provided different clinical outcomes. DLBCL-type PSL cases are more likely to be easily identified, while SBL-type PSL cases require more complete and specific diagnostic modalities to assess their classification, as in our cases.