T-cell-rich B-cell lymphoma of the spleen presenting with severe hypersplenism.
We report a 19-year-old woman who was presented with B-symptoms, massive splenomegaly, hepatomegaly and hypersplenism. She underwent diagnostic/therapeutic splenectomy. Microscopically, the spleen showed a vaguely micronodular and diffuse proliferation of lymphoid cells in the white pulp that also involved the red pulp. On immunohistochemical staining, this proliferation consisted predominantly of CD3(+), CD7(+) small T cells with the presence of a minor population of CD15(-),CD30(-), CD20(+) large atypical B cells. A liver biopsy also showed a similar morphology to that seen in the spleen. After splenectomy, only the pancytopenia improved. A combined immunochemotherapy regimen (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) was utilized, which resulted in a complete remission.
Dincol
G
G
Division of Haematology, Istanbul Medical School, Istanbul University, 34390 Capa, Istanbul, Turkey. gdincol@istanbul.edu.tr
Agan
M
M
Dogan
O
O
Diz-Kucukkaya
R
R
Uslu
B
B
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006529:Hepatomegaly / Q000209:etiology; D006651:Histocytochemistry; D006801:Humans; D006971:Hypersplenism / Q000209:etiology*; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D010198:Pancytopenia / Q000209:etiology / Q000628:therapy; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab; D013160:Splenic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D013601:T-Lymphocytes / Q000473:pathology*; D014750:Vincristine / Q000008:administration & dosage
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone