title: Discordant lymphoma consisting of splenic mantle cell lymphoma and marginal zone lymphoma involving the bone marrow and peripheral blood: a case report.
abstract: BACKGROUND
  Discordant lymphomas are rare entities characterized by the simultaneous presence of two distinct types of lymphomas in different anatomic sites. We describe a very rare case of simultaneous occurrence of splenic mantle cell lymphoma and marginal zone lymphoma involving the bone marrow and peripheral blood.
  
  
  METHODS
  We report the case of a 60-year-old asymptomatic Caucasian woman in whom discordant lymphomas were discovered when a slight lymphocytosis and a conspicuous splenomegaly were observed. The different morphological, immunophenotypical and immunohistochemical features found in the different pathologic samples obtained from peripheral blood, bone marrow and spleen sections made it possible to differentiate two types of non-Hodgkin B-cell lymphomas: a mantle cell lymphoma infiltrating the spleen and a marginal zone lymphoma involving both the bone marrow and peripheral blood. Since a similar IgH gene rearrangement was found both in the bone marrow and in the spleen, the hypothesis of a common origin, followed by a different clonal selection of the neoplastic lymphocytes may be taken into consideration.
  
  
  CONCLUSIONS
  Our case emphasizes the usefulness of investigating simultaneous specimens from different anatomic sites from the same patient and the relevant diagnostic role of splenectomy.
authors.affiliation: Department of Oncology, Transplants and New Technologies in Medicine, Division of Hematology and Section of Flow Cytometry, University of Pisa, Pisa, Italy. giovannicarulli@alice.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carulli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marini
authors.forename: Eugenio M
authors.initials: EM
authors.lastname: Ciancia
authors.forename: Joseph
authors.initials: J
authors.lastname: Bruno
authors.forename: Silvana
authors.initials: S
authors.lastname: Vignati
authors.forename: Paola
authors.initials: P
authors.lastname: Lambelet
authors.forename: Elisa
authors.initials: E
authors.lastname: Cannizzo
authors.forename: Virginia
authors.initials: V
authors.lastname: Ottaviano
authors.forename: Sara
authors.initials: S
authors.lastname: Galimberti
authors.forename: Francesco
authors.initials: F
authors.lastname: Caracciolo
authors.forename: Maria I
authors.initials: MI
authors.lastname: Ferreri
authors.forename: Elena
authors.initials: E
authors.lastname: Ciabatti
authors.forename: Mario
authors.initials: M
authors.lastname: Petrini