Difficulty in classifying a B cell chronic lymphoproliferative disorder CD5+.

Area of Science:

• Hematology
• Oncology
• Immunohistochemistry

Background:

• Splenic marginal zone lymphoma with plasmacytic differentiation presents unique diagnostic challenges.
• Accurate subtyping of non-Hodgkin lymphomas is crucial for appropriate treatment strategies.

Observation:

• A 53-year-old woman presented with asthenia, significant weight loss, and disorientation.
• Clinical examination revealed lymphadenopathy, hepatomegaly, and splenomegaly.
• Flow cytometry showed a clonal lymphocyte population with specific immunophenotypic markers.

Findings:

• Initial suspicion of mantle cell lymphoma was excluded by bone marrow biopsy and absence of cyclin D1.
• Immunohistochemical analysis and histopathology suggested a blastoid variant of small lymphocytic lymphoma.
• The case highlights the importance of comprehensive diagnostic workup in complex lymphoma cases.

Implications:

• This case underscores the diagnostic difficulties in differentiating lymphoma subtypes.
• Accurate diagnosis impacts patient prognosis and therapeutic decisions.
• Further research into the immunophenotypic profiles of rare lymphoma variants is warranted.