{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:22:35Z","timestamp":1787026955247,"version":"build-2736575974"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>The rare occurrence of diffuse large B-cell lymphoma (DLBCL) limited to the spleen presents difficulties in diagnosis. A case report details a patient whose initial symptoms were neck and shoulder pain, subsequently diagnosed as spontaneous spleen rupture, a rare complication of primary splenic lymphoma. Following a splenectomy, the patient was confirmed to have primary splenic DLBCL and made a good postoperative recovery. This report highlights the diagnostic dilemmas in atypical presentations, where neck and shoulder pain may be the only early sign of a neglected spleen rupture, lacking typical symptoms of the underlying disease. In cases of patients who are not stable, the recommended first imaging method is a focused assessment using sonography for trauma (FAST), as CT scans have a high level of sensitivity. Treatment is determined by hemodynamic status, with conservative management for stable patients and surgical intervention for unstable patients. The importance of recognizing spontaneous spleen rupture as a critical yet uncommon possibility in acute abdominal cases, especially in instances of primary splenic DLBCL, is emphasized in the report.<\/jats:p>","DOI":"10.3389\/fonc.2025.1449966","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:28:01Z","timestamp":1738628881000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual symptoms reveal a rare splenic lymphoma: a case report of PS-DLBCL with neck and shoulder pain as the initial presentation"],"prefix":"10.3389","volume":"15","author":[{"given":"Shifu","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.12.025","article-title":"Spontaneous rupture of the spleen: a rare but important differential of an acute abdomen","volume":"26","author":"Rhee","year":"2008","journal-title":"Am J Emergency Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.14735\/amgp20191201","article-title":"Rare cause of spontaneous spleen bleeding: a case report and literature review","volume":"68","author":"Nos\u00e1kov\u00e1","year":"2022","journal-title":"Vnitr Lekarstvi"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.40793","article-title":"Primary splenic diffuse large B-cell lymphoma: an atypical presentation","volume":"15","author":"Pirzada","year":"2023","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1186\/1749-7922-1-35","article-title":"Large B-cell lymphoma presenting as acute abdominal pain and spontaneous splenic rupture: A case report and review of relevant literature","volume":"1","author":"Biswas","year":"2006","journal-title":"World J Emergency Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjac211","article-title":"Spontaneous splenic rupture from indeterminate dendritic cell proliferation: a case report","volume":"2022","author":"Iqbal","year":"2022","journal-title":"J Surg Case Rep"},{"key":"B6","first-page":"2011","volume-title":"Rosai and Ackerman\u2019s Surgical Pathology","author":"Rosai","year":"2011"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2020.10.019","article-title":"Spontaneous splenic rupture in a patient with chronic myeloid leukemia: a case report","volume":"66","author":"Rueda-Esteban","year":"2020","journal-title":"Int J Surg Case Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1002\/ajh.2830380206","article-title":"Primary non-Hodgkin lymphoma of the spleen","volume":"38","author":"Brox","year":"1991","journal-title":"Am J Hematol"},{"key":"B9","article-title":"Primary Malignant neoplasms of the spleen","volume":"120","author":"Dasgupta","year":"1965","journal-title":"Surgery Gynecology Obstetrics"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196604)19:4<461::aid-cncr2820190402>3.0.co;2-x","article-title":"Malignant lymphoma of the spleen. 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