Splenic lymphoma with villous lymphocytes presenting as leucocytoclastic vasculitis.
We describe a 69-year-old woman who presented with purpura on the legs. Examination of a blood film revealed a homogenous population of abnormal lymphoid cells with villous projections. The immunophenotype was consistent with a diagnosis of splenic lymphoma with villous lymphocytes (SLVL). A type II (IgM-IgG) cryoglobulin was detected in the serum. Renal biopsy demonstrated a membranoproliferative type I glomerulonephritis with intraluminal IgG and IgM deposits, and a skin biopsy showed a leucocytoclastic vasculitis with outlining of the vessels by IgG and IgM. Vasculitis has been reported in association with a number of haematological malignancies, most frequently with hairy cell leukaemia. To our knowledge this is the first report of SLVL presenting with cryoglobulinaemic vasculitis.
Farrell
A M
AM
Department of Dermatology, Churchill Hospital, Oxford, UK.
Stern
S C
SC
El-Ghariani
K
K
Frankel
A
A
Woodrow
D
D
Muller
B
B
Cream
J J
JJ
D000368:Aged; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D013160:Splenic Neoplasms / Q000150:complications*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000209:etiology*