title: Difficulty in classifying a B cell chronic lymphoproliferative disorder CD5+.
abstract: We present the case of a 53 years old woman diagnosed with splenic marginal zone lymphomas with plasmacytic differentiation (after a lymph node biopsy), who, complained of mild asthenia, weight loss (about 10 kg in 9 months), spatial disorientation during the last period. The clinical examination revealed slight pallor, normal cardiovascular and respiratory examination; painful cervical, about 5cm in diameter and also non-painful inguinal lymphadenopathies, increased consistency, freely movable, about 2 cm in diameter. The patient presented enlarged liver (lower limit at 3 cm below the ribs) and spleen (inferior pole at the ombilicus). The laboratory tests showed leucocytosis with lymphocytosis-a clonal population of lymphocytes- CD19+, CD20low+, CD22+, CD5low+, CD24+, CD200low+, CD79B+, CD43-, FMC7+/-, CD10+/-, CD34-, BCL2+, TdT-, CD34-, CD10-, CD3-. We suggested the diagnosis of mantle cell lymphoma, blastoid variant and performed a bone marrow biopsy . The bone marrow biopsy excluded the diagnosis of mantel cell lymphoma, based on the absence of cycline D1. The histopathological appearance and the immunohistochemical tests (CD20+, CD79a+, CD5low+, TdT-, CD34-cycline D1-) suggested a blastoid variant of small lymphocytic lymphoma.
authors.affiliation: Department of Hematology, Emergency Universitary Hospital Bucharest, "Carol Davila" University of Medicine and Pharmacy, Bucharest.
authors.forename: Anamaria
authors.initials: A
authors.lastname: Iova
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Vladareanu
authors.forename: Daniela
authors.initials: D
authors.lastname: Vasile
authors.forename: H
authors.initials: H
authors.lastname: Bumbea
mesh_terms: D001853:Bone Marrow / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000145:classification / Q000175:diagnosis*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis; D008875:Middle Aged