Splenic Micronodular T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: The Corticosteroid Pretreatment Hypothesis

Benzion Samueli, Karen Nalbandyan, Daniel Benharroch, Itai Levi

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Splenic micronodular T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is derived from diffuse large B-cell lymphoma N.O.S., perhaps with some affinity with nodal THRLBCL. Of note, in contrast with the latter, the only lymph nodes involved in association with the splenic micronodular pattern of the disease are the splenic hilar lymph nodes. The possibility that corticosteroids, when prescribed prior to splenectomy, cause histopathological and functional modulations, apoptosis, necrosis, tissue shrinkage, which may obscure the diagnostic morphological features of this variant lymphoma and cause an underdiagnosis of this condition. The indications for glucocorticoid therapy are either related to the lymphoma itself, or else to other comorbidities, like asthma and autoimmune disorders. We propose that patients with the splenic subset of the disease are likely to have been prescribed corticosteroids prior to histopathologic examination of the involved spleen, causing disparate morphologies. However, a reviewer might accidentally dismiss the corticosteroid pretreatment which is thus overlooked. Apoptosis, induced by corticosteroids, is hypothesized as the major mechanism initiating the histopathological and functional changes in the splenic micronodular variant of the lymphoma.

Original languageEnglish
Pages (from-to)310-317
Number of pages8
JournalActa Haematologica
Volume145
Issue number3
DOIs
StatePublished - 1 May 2022
Externally publishedYes

Keywords

  • Apoptosis
  • Corticosteroids
  • Shrinkage
  • Splenic micronodular B-cell lymphoma

ASJC Scopus subject areas

  • Hematology

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