{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T18:07:54Z","timestamp":1755799674163,"version":"3.44.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"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>Gastrosplenic fistula is a rare complication, most often secondary to gastric or splenic lymphoma. Severe gastrosplenic fistula can cause life-threatening upper gastrointestinal bleeding, making early diagnosis and intervention critical for a favorable prognosis. Currently, surgical intervention remains the primary treatment; however, outcomes are often suboptimal. In this paper, we present a case involving ultrasound-guided interventional diagnosis and treatment of gastrosplenic fistula caused by diffuse large B-cell lymphoma. An 18-year-old male initially presented with gastric distension and epigastric pain and was diagnosed with gastric non-Hodgkin lymphoma (diffuse large B-cell lymphoma) at an outside hospital before being referred to our institution for further management. Contrast-enhanced CT revealed an abnormal density lesion between the gastric fundus and spleen, suggestive of gastric perforation accompanied by adjacent exudation and localized abscess formation. A multidisciplinary team evaluation identified markedly elevated inflammatory markers and poor overall condition, rendering the patient unsuitable for immediate surgery. Subsequent B-mode ultrasound and contrast-enhanced ultrasound (CEUS) precisely delineated the fistula location and extent of the abscess, enabling determination of a safe puncture path. Ultrasound-guided percutaneous catheter drainage of the gastrosplenic fistula was then successfully performed. Post-procedural intracavitary contrast injection confirmed correct catheter tip placement distal to the fistula. Follow-up CT imaging 20 days after drainage showed a significant reduction in the encapsulated fluid and gas collection at the fistula site. After one month of clinical improvement, the patient underwent total gastrectomy with resection of the pancreatic body-tail and spleen. He was subsequently discharged and continued maintenance chemotherapy for non-Hodgkin lymphoma. At 13 months postoperatively, the patient remains clinically stable with normal vital signs.<\/jats:p>","DOI":"10.3389\/fonc.2025.1638866","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T04:14:24Z","timestamp":1755663264000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Ultrasound-guided interventional diagnosis and treatment of gastrosplenic fistula caused by lymphoma"],"prefix":"10.3389","volume":"15","author":[{"given":"Yahan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manxi","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i35.6491","article-title":"Gastrosplenic fistula occurring in lymphoma patients: Systematic review with a new case of extranodal NK\/T-cell lymphoma","volume":"23","author":"Kang","year":"2017","journal-title":"World J Gastroenterol"},{"key":"B2","article-title":"Gastrosplenic fistula following chemotherapy for lymphoma","author":"Moghazy","year":"2008","journal-title":". Gulf J Oncolog"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1986-8","article-title":"Asymptomatic gastrosplenic fistula in a patient with marginal zonal lymphoma transformed to diffuse large B cell lymphoma\u2013a case report and review of literature","volume":"93","author":"Senapati","year":"2014","journal-title":"Ann Hematol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1256935","article-title":"Gastrosplenic fistula secondary to lymphoma, manifesting as upper gastrointestinal bleeding","author":"Dellaportas","year":"2011","journal-title":"Endoscopy"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-022-01551-5","article-title":"Gastrosplenic Fistula: a Systematic Review","volume":"13","author":"Borgharia","year":"2022","journal-title":"Indian J Surg Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2967\/jnmt.122.264789","article-title":"Gastrosplenic fistula secondary to simultaneous gastric and splenic diffuse large B-cell lymphoma","volume":"51","author":"Ale Ali","year":"2023","journal-title":"J Nucl Med Technol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.7695","article-title":"Gastrosplenic fistula from Hodgkin\u2019s lymphoma","volume":"27","author":"Seib","year":"2009","journal-title":"J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.09.015","article-title":"Spontaneous gastrosplenic fistula secondary to diffuse large B-cell lymphoma","volume":"73","author":"Jain","year":"2011","journal-title":"Gastrointest Endosc"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1177\/00031348221117045","article-title":"Management of massive upper gastrointestinal hemorrhage secondary to gastrosplenic fistula","volume":"89","author":"Chopra","year":"2023","journal-title":"Am Surg"},{"key":"B10","article-title":"Gastrosplenic fistula: etiologies, diagnostic studies, and surgical management","volume":"95","author":"Rothermel","year":"2010","journal-title":"Int Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"bcr0420102932","DOI":"10.1136\/bcr.04.2010.2932","article-title":"Spontaneous gastrosplenic fistula secondary to primary splenic lymphoma","author":"Khan","year":"2010","journal-title":"BMJ Case Rep"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-018-1473-8","article-title":"Contrast-enhanced ultrasound (CEUS) in abdominal intervention","volume":"43","author":"Huang","year":"2018","journal-title":"Abdom Radiol (NY)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1159\/000500505","article-title":"Successful treatment of gastrosplenic fistula arising from diffuse large B-cell lymphoma with chemotherapy: two case reports","volume":"12","author":"Saito","year":"2019","journal-title":"Case Rep Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/SGA.0000000000000637","article-title":"Spontaneous gastrosplenic fistula: an unusual presentation of diffuse large B cell lymphoma","volume":"45","author":"B\u00fclb\u00fcl","year":"2022","journal-title":"Gastroenterol Nurs"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-200295080-00034","article-title":"Primary splenic lymphoma complicated by hematemesis and gastric erosion","volume":"95","author":"Bird","year":"2002","journal-title":"South Med J"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.8518","article-title":"Type V gastric ulcer: An unusual etiology of gastrosplenic fistula associated with upper gastrointestinal bleeding","volume":"12","author":"Yousaf","year":"2024","journal-title":"Clin Case Rep"},{"key":"B17","first-page":"69","article-title":"Gastrosplenic fistula due to splenic large cell lymphoma diagnosed by percutaneous drainage before surgical treatment","volume":"19","author":"Ariba\u015f","year":"2008","journal-title":"Turk J Gastroenterol"},{"key":"B18","unstructured":"Epidermoid cyst\n          \n          \n            \n              Zito\n              PM\n            \n            \n              Scharf\n              R\n            \n          \n          29763149\n          Treasure Island (FL\n          StatPearls Publishing\n          StatPearls\n          \n          2025"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1638866\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T04:14:29Z","timestamp":1755663269000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1638866\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":18,"alternative-id":["10.3389\/fonc.2025.1638866"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1638866","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2025,8,20]]},"article-number":"1638866"}}