DIFFUSE LARGE B-CELL LYMPHOMA COMPLICATED BY BLEEDING FROM VARICOSE VEINS OF THE STOMACH AGAINST THE BACKGROUND OF SINISTRAL PORTAL HYPERTENSION. CASE STUDY AND LITERATURE REVIEW
DOI:
https://doi.org/10.15407/exp-oncology.2025.01.102Keywords:
diffuse large B-cell lymphoma, splenic vein thrombosis, sinistral portal hypertension, bleeding.Abstract
Among 11,152 patients treated for complicated portal hypertension (PH) in the Kyiv Emergency Hospital in 2000— 2023, 394 (3.5%) had sinistral portal hypertension (SPH), the etiological factor of which in one patient (0.25% of SPH cases, 0.009% of all PH cases) was diffuse large B-cell lymphoma (DLBCL). We provide an example of successful surgical treatment of a patient with DLBCL that was complicated by the development of SPH with bleeding from varicose veins of the stomach. A peculiarity and difference between SPH and other forms of PH is not only the preserved patency of the portal vein and the normal gradient of portal pressure but also the preserved liver function.
References
Mansour N, Sirtl S, Angele MK, et al. Management of sinistral portal hypertension after pancreaticoduodenectomy. Dig Dis. 2024;42(2):178-185. https://doi:10.1159/000535774
Kyaw AM, Aye TT, Htun LL. Diffuse large B cell lymphoma with cutaneous and gastrointestinal involvement. Case Rep Gastrointest Med. 2022;2022:2687291. https://doi:10.1155/2022/2687291
Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia. 2022;36(7):1720-1748. https://doi.org/10.1038/ s41375-022-01620-2
Xie M, Zhang Q, Guo R, et al. Clinical features of diffuse large B-cell lymphoma in head and neck. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022;36(1):1-7. https://doi.org/10.13201/j.issn.2096-7993.2022.01.001 (in Chinese).
Bai Z, Zhou Y. A systematic review of primary gastric diffuse large B-cell lymphoma: Clinical diagnosis, staging, treatment and prognostic factors. Leuk Res. 2021;111:106716. https://doi.org/10.1016/j.leukres.2021.106716
Juárez-Salcedo LM, Sokol L, Chavez JC, et al. Primary gastric lymphoma, epidemiology, clinical diagnosis, and treatment. Cancer Control. 2018;25(1):1073274818778256. https://doi.org/10.1177/1073274818778256
Couto ME, Oliveira I, Domingues N, et al. Gastric diffuse large B-cell lymphoma: a single-center 9-year experience.
Indian J Hematol Blood Transfus. 2021;37(3):492-496. https://doi.org/10.1007/s12288-020-01391-9
Facchinelli D, Boninsegna E, Visco C, et al. Primary pancreatic lymphoma: recommendations for diagnosis and management. J Blood Med. 2021;12:257-267. https://doi.org/10.2147/JBM.S273095
Lee E, Kang MK, Moon G, et al. Hepatic involvement of diffuse large B-cell lymphoma mimicking antinuclear antibody-negative autoimmune hepatitis diagnosed by liver biopsy. Medicina (Kaunas). 2022;59(1):77. https://doi. org/10.3390/medicina59010077
Wadsworth PA, Miranda RN, Bhakta P, et al. Primary splenic diffuse large B-cell lymphoma presenting as a splenic abscess. EJHaem. 2023;4(1):226-231. https://doi.org/10.1002/jha2.642
Taibi S, Jabi R, Kradi Y, et al. Diffuse large B-cell lymphoma revealed by splenic abscess: a case report. Cureus.
;13(10):e18771. https://doi.org/10.7759/cureus.18771
Seijari MN, Kaspo S, Alshurafa A, et al. Primary splenic diffuse Large B-cell lymphoma: a case report and literature review of a rare condition. Case Rep Oncol. 2024;17(1):447-453. https://doi.org/10.1159/000537780
Kusuma VP, Vidyani A. Diffuse large B-cell lymphoma from duodenal with hematemesis, melena, and obstruction jaundice symptoms: a rare case. Int J Surg Case Rep. 2023;113:109046. https://doi.org/10.1016/j.ijscr.2023.109046
Singh V, Gor D, Gupta V, et al. Epidemiology and determinants of survival for primary intestinal non-Hodgkin lymphoma: a population-based study. World J Oncol. 2022;13(4):159-171. https://doi.org/10.14740/wjon1504
Wang J, Han J, Xu H, et al. Primary duodenal papilla lymphoma producing obstructive jaundice: a case report. BMC Surg. 2022;22(1):110. https://doi.org/10.1186/s12893-022-01558-3
Tutchenko M, Rudyk D, Besedinskyi M. Decompensated portal hypertension complicated by bleeding. Emergency Med. 2024;20(1):13-18. https://doi.org/10.22141/2224-0586.20.1.2024.1653 (in Ukrainian).
Song YH, Xiang HY, Si KK, et al. Difference between type 2 gastroesophageal varices and isolated fundic varices in clinical profiles and portosystemic collaterals. World J Clin Cases. 2022;10(17):5620-5633. https://doi.org/10.12998/ wjcc.v10.i17.5620
Watanabe Y, Osaki A, Yamazaki S, et al. Two cases of gastric varices with left-sided portal hypertension due to essential thrombocythemia treated with gastric devascularization or partial splenic embolization. Intern Med. 2023;62(19):2839-2846. https://doi.org/10.2169/internalmedicine.1273-22
Chen BB, Mu PY, Lu JT, et al. Sinistral portal hypertension associated with pancreatic pseudocysts - ultrasonogra- phy findings: a case report. World J Clin Cases. 2021;9(2):463-468. https://doi.org/10.12998/wjcc.v9.i2.463
Mayer P, Venkatasamy A, Baumert TF, et al. Left-sided portal hypertension: Update and proposition of manage- ment algorithm. J Visc Surg. 2024; 161(1):21-32. https://doi.org/10.1016/j.jviscsurg.2023.11.005
Zheng K, Guo X, Feng J, et al. Gastrointestinal bleeding due to pancreatic disease-related portal hypertension. Gas- troenterol Res Pract. 2020;2020:3825186. https://doi.org/10.1155/2020/3825186
Ono Y, Inoue Y, Kato T, et al. Sinistral portal hypertension after pancreaticoduodenectomy with splenic vein resection: Pathogenesis and its prevention. Cancers (Basel). 2021;13(21):5334. https://doi.org/10.3390/cancers 13215334
Liu M, Wei N, Song Y. Splenectomy versus non-splenectomy for gastrointestinal bleeding from left-sided portal hy- pertension: a systematic review and meta-analysis. Therap Adv Gastroenterol. 2024;17:17562848241234501. https:// doi.org/10.1177/17562848241234501
Robles-Medranda C, Oleas R, Valero M, et al. Endoscopic ultrasonography-guided deployment of embolization coils and cyanoacrylate injection in gastric varices versus coiling alone: a randomized trial. Endoscopy. 2020;52(4):268- 275. https://doi.org/10.1055/a-1123-9054
Mohan BP, Chandan S, Khan SR, et al. Efficacy and safety of endoscopic ultrasound-guided therapy versus direct en- doscopic glue injection therapy for gastric varices: systematic review and meta-analysis. Endoscopy. 2020;52(4):259- 267. https://doi.org/10.1055/a-1098-1817
Shah KY, Ren A, Simpson RO, et al. Combined transjugular intrahepatic portosystemic shunt plus variceal obli- teration versus transjugular intrahepatic portosystemic shunt alone for the management of gastric varices: Com- parative single-center clinical outcomes. J Vasc Interv Radiol. 2021;32(2):282-291.e1. https://doi.org/10.1016/ j.jvir.2020.10.009
Stein DJ, Salinas C, Sabri S, et al. Balloon retrograde transvenous obliteration versus endoscopic cyanoacrylate in bleeding gastric varices: Comparison of rebleeding and mortality with extended follow-up. J Vasc Interv Radiol. 2019;30(2):187-194. https://doi.org/10.1016/j.jvir.2018.12.008
Robles-Medranda C, Oleas R, Valero M, et al. Endoscopic ultrasonography-guided deployment of emboliza- tion coils and cyanoacrylate injection in gastric varices versus coiling alone: a randomized trial. Endoscopy. 2020; 52(4):268-275. https://doi.org/10.1055/a-1123-9054
Mohan BP, Chandan S, Khan SR, et al. Efficacy and safety of endoscopic ultrasound-guided therapy versus direct en- doscopic glue injection therapy for gastric varices: systematic review and meta-analysis. Endoscopy. 2020;52(4):259- 267. https://doi.org/10.1055/a-1098-1817
Kouanda A, Binmoeller K, Hamerski C, et al. Safety and efficacy of EUS-guided coil and glue injection for the pri- mary prophylaxis of gastric variceal hemorrhage. Gastrointest Endosc. 2021;94(2):291-296. https://doi.org/10.1016/ j.gie.2021.01.025
Gillespie SL, McAvoy NC, Yung DE, et al. Thrombin is an effective and safe therapy in the management of bleeding gastric varices. A real-world experience. J Clin Med. 2021;10(4):785. https://doi.org/10.3390/jcm10040785
Lo GH, Lin CW, Tai CM, et al. A prospective, randomized trial of thrombin versus cyanoacrylate injection in the control of acute gastric variceal hemorrhage. Endoscopy. 2020;52(7):548-555. https://doi.org/10.1055/a-1127-3170
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Experimental Oncology

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.