Cancer Res Treat.  2002 Apr;34(2):153-156.

Gastrosplenic Fistula Complicated in a Patient with Non- Hodgkin's Lymphoma

• Yang SE
• Jin JY
• Song CW
• Park JC
• Lee JI
• Kim W
• Kim J
• Lee HG

Abstract

Reported cases of gastrosplenic fistulas are extremely rare in the literature. Malignancy is the primary cause in 50% of patients, followed by perforated peptic ulcer (40%). Fistulas can cause spleen rupture and potential bleeding that threaten the life of the patient. Lymphoma is the most common cause of malignancy complicated with gastrosplenic fistula. Most gastrosplenic fistulae caused by lymphoma eventually close following chemotherapy, although splenectomy should be performed to avoid further complications. We experienced a case of non-Hodgkin's lymphoma complicated with gastrosplenic fistula in a 21 year-old man. He was admitted to our hospital because of LUQ mass. On the abdominal CT, a splenic mass with central necrosis and gas was discovered. The biopsy specimen of the stomach and spleen displayed diffuse, large B cell type non-Hodgkin's lymphoma. After one cycle of CHOP chemotherapy, the LUQ mass was markedly regressed although the gastrosplenic fistula was still present on the follow-up CT. The fistula was treated by splenectomy and a partial resection of gastric fundus. Follow-up chemotherapy was continued after surgery.

Keyword

Non-Hodgkin's lymphoma; Gastrosplenic fistula; Splenectomy

MeSH Terms

Biopsy
Drug Therapy
Fistula*
Follow-Up Studies
Gastric Fundus
Hemorrhage
Hodgkin Disease*
Humans
Lymphoma
Lymphoma, Non-Hodgkin
Necrosis
Peptic Ulcer
Rupture
Spleen
Splenectomy
Stomach
Tomography, X-Ray Computed
Young Adult