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[Primary splenic lymphoma with hypoplastic bone marrow].

Y Yoshioka1, N Kawamata, E Sato

  • 1Department of Medicine, Juntendo University School of Medicine.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|April 13, 1999
PubMed
Summary
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This study details a patient initially diagnosed with aplastic anemia who was later found to have primary splenic lymphoma with bone marrow infiltration. Treatment led to remission, but relapse occurred, suggesting a link between lymphoma and bone marrow hypoplasia possibly mediated by cytokines.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • A 44-year-old male presented with persistent fever and pancytopenia, initially diagnosed as aplastic anemia.
  • Treatment for aplastic anemia included glucocorticoids and granulocyte colony-stimulating factor.
  • Splenomegaly was noted, leading to splenectomy.

Observation:

  • Pathological examination of the spleen revealed diffuse large B-cell non-Hodgkin's lymphoma.
  • Bone marrow biopsy showed infiltration by lymphoma cells and complex chromosomal abnormalities.
  • No lymphadenopathy was observed, leading to a diagnosis of primary splenic lymphoma with bone marrow involvement.

Findings:

  • Chemotherapy resulted in bone marrow recovery and disappearance of karyotype abnormalities.
  • Pancytopenia and bone marrow lymphoma recurrence were observed six months post-treatment.

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  • The hypoplastic bone marrow state was hypothesized to be associated with the lymphoma, potentially involving cytokines like interferon-gamma.

    • Implications:

    • This case highlights the diagnostic challenges in differentiating aplastic anemia from lymphoma infiltration.
    • It underscores the importance of thorough pathological examination, including bone marrow biopsy, in cases of unexplained cytopenias and splenomegaly.
    • The findings suggest a potential role for cytokines in mediating bone marrow hypoplasia secondary to lymphoma, warranting further investigation.