A Case Report on Non-Hodgkin Lymphoma with Spleenomegaly and Pancytopenia: Challenges in Management and Role of Emergency Splenectomy

Abstract The 47-year-old female presented with progressive left-sided abdominal fullness, splenomegaly, and pancytopenia, and was diagnosed with Splenic Marginal Zone Lymphoma (SMZL) through histopathological findings of lymphoid cell infiltration in the spleen and hilar lymph nodes, supported by positive immunohistochemistry and flow cytometry. Despite initial treatment with six doses of Rituximab monotherapy, the patient did not respond, prompting a timely shift to a more systemic management approach with the R-CVP regimen, tailored to her age and thrombocytopenia. When symptoms persisted, an emergency splenectomy was skillfully performed to provide symptomatic relief and enhance survival, with surgical risks meticulously managed.This timely and decisive intervention proved crucial, and the patient has since shown remarkable improvement. At her follow-up visit post-surgery, she is tolerating treatment well and is in good health, demonstrating the success of the comprehensive and adaptive care provided.