SPLENIC EXTRAMEDULLARY HEMATOPOIESIS IN A PATIENT RECEIVING INTERMITTENTLY ADMINISTERED GRANULOCYTE-COLONY-STIMULATING FACTOR

A 22-year-old man received four cycles of cyclophosphamide, vincristine, doxorubicin, prednisone, and etoposide with intermittent granulocyte colony-stimulating 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.