Clinicopathological analysis of primary splenic diffuse large B-cell lymphoma

Summary Splenic infiltration is often seen in diffuse large B-cell lymphoma(DLBCL). However, primary splenic DLBCL is rare and studies on its clinicopathological features are limited. We assessed 66 cases of primary splenic DLBCL and 309 control DLBCL, not otherwise specified. Hepatitis C virus antibody prevalence, B symptoms, poor performance statusand CD5positivity differed significantly between the primary splenic DLBCL and control DLBCL groups. Primary splenic DLBCL cases were classified histopathologically into two groups [ white pulppattern (n = 46), red pulppattern (n = 20)]. Survival analysisshowed no difference in overall survival between the primary splenic DLBCL and the control group, but the former had a more favourable progression-free survival. In the examination of primary splenic DLBCL, the white pulppattern was statistically associated with a lower performance status(2–4), and a lower CD5positivity than the red pulppattern. In the survival analysis, the red pulppattern demonstrated poorer overall survival. Multivariate analysis of overall survival in primary splenic DLBCL cases identified CD5positivity as an indicator of poor prognosis. Classifying primary splenic DLBCL into white and red pulppatterns was useful in terms of clinicopathological features and overall survival.