Hepatitis C virus and splenic non-Hodgkin lymphoma. Report of two cases not associated with mixed cryoglobulinemia

Problem: HCV infection, alone or in combination with other factors, may be responsible for clonal B-cell expansion underlying systemic manifestations of mixed cryoglobulinemia (MC), and may explain the appearance of a malignant NHL in some subjects. Methods: We reported two cases of primary splenic B-cell NHL associated with HCV infection, without any evidence of MC preceding lymphoproliferative disease. Both patients were male, 44 and 40 year-old, respectively, at the time of malignancy diagnosis. Results: They went to a diagnostic splenectomy and were treated with classic chemotherapy schedules. During treatment, they had flare-up aminotransferases. Conclusion: We, as other authors, suggested that HCV infection must be searched in all patients with isolated splenic lymphoma, even in the absence of MC, and that patients with chronic HCV infection should be frequently monitored for the development of splenic NHL.