Case Report: Ultrasound-guided percutaneous splenic biopsy as a lifesaving diagnostic modality in B-cell lymphoma presenting as hemophagocytic lymphohistiocytosis: a report of two cases.

Zhuohang Zou, Yang Dai, Xushu Zhong, Jun Wang, Ailin Zhao, Yijun Wu, Ting Niu

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Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Zhuohang Zou *Department of Hematology, Institute of Hematology, and Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Yang Dai *Department of Hematology, Institute of Hematology, and Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Xushu ZhongDepartment of Hematology, Institute of Hematology, and Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Jun WangDepartment of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Ailin ZhaoDepartment of Hematology, Institute of Hematology, and Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Yijun WuDepartment of Hematology, Institute of Hematology, and Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Ting NiuDepartment of Hematology, Institute of Hematology, and Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

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6 · The paper itself

Abstract

Background: Hemophagocytic lymphohistiocytosis (HLH) as the initial manifestation of B-cell lymphoma poses significant diagnostic challenges, particularly when conventional tissue biopsy is contraindicated due to severe cytopenias and coagulopathy. Case description: We report two cases of B-cell lymphoma initially presenting with HLH, fulfilling HLH-2004 diagnostic criteria. Given the predominant splenic involvement and high bleeding risk, ultrasound-guided percutaneous splenic biopsy was performed, yielding a definitive histopathological diagnosis and guiding subsequent targeted therapy. Conclusion: Ultrasound-guided percutaneous splenic biopsy may serve as a viable diagnostic option in carefully selected patients with lymphoma-associated HLH and predominant splenic involvement, particularly when conventional approaches are inadequate or contraindicated. Its application requires thorough multidisciplinary risk-benefit assessment.

Indexed as

diagnostic dilemmahemophagocytic lymphohistiocytosislymphomasplenic lymphomaultrasound-guided percutaneous splenic biopsy

Identifiers

PMID42370155

DOI10.3389/fonc.2026.1885572

PMCPMC13303101

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