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Splenic Extramedullary Hematopoiesis in a Patient Receiving Intermittently Administered Granulocyte ColonyStimulating Factor
- Patrick P. Litam, MD;
- Henry D. Friedman, MD; and
- Thomas P. Loughran Jr., MD
- From the Veterans Administration Medical Center and the State University of New York Health Science Center, Syracuse, New York. Requests for Reprints: Patrick P. Litam, MD, Department of Medicine, State University of New York Health Science Center, 750 East Adams Street, Syracuse, NY 13210. Grant Support: In part by grants CA 46903 and CA 54552 from the National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Abstract
A 22-year-old man received four cycles of cyclophosphamide, vincristine, doxorubicin, prednisone, and etoposide with intermittent granulocyte colonystimulating factor (G-CSF) for the treatment of a high-grade, stage I malignant lymphoma involving the axilla. On re-evaluation, the axillary mass had completely disappeared; however, splenomegaly was present and lactate dehydrogenase levels were elevated 3 weeks after his final chemotherapy and G-CSF treatments. Because refractory disease was a concern, splenectomy was done. Spleen sections showed extramedullary hematopoiesis but no lymphomatous involvement. To our knowledge, we report the first case of splenomegaly with extramedullary hematopoiesis in a patient receiving intermittent G-CSF therapy. Clinicians should be aware that splenomegaly occurring in this setting does not necessarily indicate refractory lymphoma.
- Copyright 2004 by the American College of Physicians
