[Splenic lymphoma with villous lymphocytes revealed by purpura pigmentosa progressiva associated with cryoglobulinemia and chronic hepatitis C infection].
BACKGROUND
Splenic lymphoma with villous lymphocytes is occasionally associated with chronic hepatitis C infection. Antiviral hepatitis C therapy has been recently reported to be efficacious against splenic lymphoma with villous lymphocytes. We report a new case revealed by cutaneous symptoms.


METHODS
A 53-year-old patient with arthritis and neuropathy of the lower limbs consulted for vascular purpura on both legs. The blood picture showed an increase in villous lymphocytes leading to a diagnosis of splenic lymphoma with villous lymphocytes. Histologic examination of a cutaneous biopsy specimen showed thrombosis of the superficial dermal vessels, associated with cryoglobulinemia with renal and neurologic failure, a satellite of hepatitis C virus infection. The patient was treated with interferon, ribavirin and plasmapheresis.


CONCLUSIONS
Vascular purpura, often associated with cryoglobulinemia, may reveal chronic hepatitis C infection. The efficacy of interferon and ribavirin treatment for splenic lymphoma with villous lymphocytes associated with hepatitis C infection has already been documented, and results in remission of cryoglobulinemia and lymphoma as well a eradication of viral load in 78% patients.
Lemordant
P
P
Service de Dermatologie, HIA Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon.
Boye
T
T
Fournier
B
B
Guennoc
B
B
Kaplanski
G
G
Menard
G
G
Carsuzaa
F
F
D003449:Cryoglobulinemia / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011693:Purpura / Q000150:complications*; D013160:Splenic Neoplasms / Q000150:complications*