HEPATOSPLENIC T-CELL LYMPHOMA AS A CAUSE OF HYPERSPLENISM: A RARE CASE OF NON-HODGKIN LYMPHOMA REQUIRING SPLENECTOMY

Resumen

Hepatosplenic T-cell lymphoma (HSTCL) represents a rare and aggressive subset of peripheral T-cell lymphomas with complex diagnostic challenges. We present the case of a 26-year-old male who presented with progressive hepatosplenomegaly, persistent pancytopenia, and recurrent infections. Initial diagnostic workup, including multiple splenic biopsies and bone marrow evaluation, proved inconclusive. The patient underwent therapeutic splenectomy due to severe hypersplenism, yielding a 3,970g specimen. Despite postoperative complications requiring damage control surgery, the patient achieved sustained hematological improvement. Immunohistochemical analysis of the splenectomy specimen revealed an atypical T-cell population (CD2+/-, CD3+, CD7+) with CD56 coexpression, confirming HSTCL. This case emphasizes the importance of comprehensive differential diagnosis in cryptogenic hepatosplenomegaly and highlights splenectomy as both a diagnostic and therapeutic tool. Further research at specialized centers is warranted to better understand the long-term outcomes and potential benefits of splenectomy in HSTCL management.