title: Follicular lymphoma presenting with marked splenomegaly: report of three cases.
abstract: Marked splenomegaly as the main presenting sign in follicular lymphoma (FL) is rare. The clinical and morphologic findings of 3 FL patients with massive splenomegaly and slight or no lymphadenopathy are presented. All cases had massive splenomegaly, and 2 had minimal peripheral lymphadenopathy with bone marrow infiltration, which is the major involved site besides the spleen. Histologically, various sizes of micronodules, composed of medium-sized centrocytes, were present in the white pulp in 2 cases in whom splenectomy was performed. The other case was complicated by nephrotic syndrome and showed aggregates of packed small lymphocytes in the spleen and renal parenchyma. Tumor cells were positive for CD10, CD20, bcl-2, and bcl-6. Since these cases are clinically similar to splenic marginal zone lymphoma, recognition of this disease and selection of the appropriate therapy are needed.
authors.affiliation: Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Gunma University Hospital, Maebashi, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Koiso
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yokohama
authors.forename: Takeki
authors.initials: T
authors.lastname: Mitsui
authors.forename: Takayuki
authors.initials: T
authors.lastname: Saitoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murakami
authors.forename: Junko
authors.initials: J
authors.lastname: Hirato
authors.forename: Masaru
authors.initials: M
authors.lastname: Kojima
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nojima
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsukamoto
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007621:Karyotyping; D008224:Lymphoma, Follicular / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009404:Nephrotic Syndrome / Q000150:complications; D049268:Positron-Emission Tomography; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D013163:Splenomegaly / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents