Isolated gastric variceal bleeding caused by splenic lymphoma-associated splenic vein occlusion

Figure 1 Engorged varices at the cardia and high body of the stomach, with active bleeding.

Figure 2 Imaging findings. A: Axial contrast-enhanced abdominal computed tomography (CT) at the level of the splenic hilum shows a large low-attenuation mass in the enlarged spleen. The mass involves the splenic vein with near total occlusion (arrow); B: The development of a gastric varice (arrowhead) at the fundus; C: The 6-mo follow-up CT shows that the splenic mass has almost completely resolved, allowing the splenic vein (arrow) to return to patency.

Figure 3 Pathologic findings (hematoxylin/eosin staining) and immunohistochemical staining. A: The predominant fibrous tissue with necrotic foci and scattered atypical cells characterized by pleomorphic and hyperchromatic nuclei with discohesive arrangement. B: The B-lymphocyte marker (CD20) was strongly positive in the atypical cells.