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Published 14 April 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.09.2008.0974]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Rare disease

Rapid improvement of massive bloody pleural effusion after splenectomy for splenic marginal zone lymphoma

Miyuki Okuda1, Nobuya Tanaka1, Makoto Kashio1, Noriyuki Sagara1, Katsuyuki Aozasa2, Yoshinari Okuda3, Izuo Tsuyuguchi1

1 Osaka Hospital, Neyagawakoen 2276-1, Neyagawa City, Osaka, 572–0854, Japan
2 Department of Pathology (C3), Osaka University Graduate School of Medicine, Osaka, Japan, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan
3 Okuda Clinic, Uchiage1123, Neyagawa, Osaka, 572, Japan

Correspondence to:
Miyuki Okuda, ryoheikunn{at}msf.biglobe.ne.jp

SUMMARY

Splenic marginal zone lymphoma (SMZL) is a rare malignant lymphoma involving marginal zone B cells, accounting for only 1% of non-Hodgkin lymphomas. No previous reports have documented SMZL accompanied by massive bloody pleural effusion. Herein, the case of a patient with SMZL that was only diagnosed after splenectomy and thoracoscopic pleural biopsy is presented. SMZL in this patient was accompanied by massive bloody pleural effusion. The characteristics of the patient’s pleural effusion changed from bloody to transudative after splenectomy, and rapid improvement was observed. It was considered that the splenectomy was valid for treatment of unidentified pleural effusion with enlarged spleen.


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