Gastrosplenic fistula following successful chemotherapy for disseminated histiocytic lymphoma

Abstract

A case is presented of a patient with diffuse histiocytic lymphoma with splenic involvement who developed a communication between the greater gastric curvature and the splenic parenchyma after successful antineoplastic chemotherapy. This fistula was diagnosed by CT scan and confirmed by upper gastrointestinal barium series and fiberoptic endoscopy. This complication was managed successfully by an enbloc resection of the greater curvature of the stomach, splenectomy, and distal pancreatectomy. Histologic assessment of the stomach and spleen failed to reveal residual tumor. The clinical evolution of this rare complication is discussed and the literature on this subject is reviewed.