title: Splenic lymphoma with villous lymphocytes presenting as leucocytoclastic vasculitis.
abstract: 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.
authors.affiliation: Department of Dermatology, Churchill Hospital, Oxford, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Farrell
authors.forename: S C
authors.initials: SC
authors.lastname: Stern
authors.forename: K
authors.initials: K
authors.lastname: El-Ghariani
authors.forename: A
authors.initials: A
authors.lastname: Frankel
authors.forename: D
authors.initials: D
authors.lastname: Woodrow
authors.forename: B
authors.initials: B
authors.lastname: Muller
authors.forename: J J
authors.initials: JJ
authors.lastname: Cream
mesh_terms: 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*