Localized reactive lymphoid hyperplasia of the spleen simulating malignant lymphoma

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Abstract
Isolated, solitary nodules were discovered in 7 [human] spleens due to reactive lymphoid hyperplasia. Six cases were encountered at staging laparotomy for malignant lymphoma and one case was observed in a spleen resected because of autoimmune hemolytic anemia. Macroscopically, the nodules were strongly suggestive of splenic involvement by lymphoma; microscopically, splenic lymphoma was not demonstrated in any case. In 4 spleens the nodules were formed by focal aggregation of reactive germinal centers. In 3 other cases the nodules were manifestations of a localized proliferation of lymphocytes, including immunoblasts and plasma cells. The immunoblasts raised the question of splenic involvement by Hodgkin''s disease, but Reed-Sternberg cells were not identified. Etiology of localized splenic lymphoid hyperplasia is unknown, but the lesion is likely analogous to florid reactive follicular and diffuse hyperplasia observed in a solitary enlarged lymph node simulating malignant lymphoma.