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Symptomatic Massive Splenomegaly in Persistent Polyclonal B-cell Lymphocytosis Requiring Splenectomy
Shanel B Bhagwandin1, Elliot S Weisenberg2, Howard Ozer3
1Department of Surgery, University of Illinois at Chicago Medical Center, Chicago, Illinois.
Open Journal of Clinical & Medical Case Reports
|December 23, 2015
Summary
Persistent polyclonal B-cell lymphocytosis (PPBL) can cause massive splenomegaly, mimicking lymphoma. This case highlights the diagnostic challenges and management strategies for this rare hematological disorder.
Area of Science:
- Hematology
- Oncology
Background:
- Persistent polyclonal B-cell lymphocytosis (PPBL) is a rare hematological disorder.
- Characterized by binucleated lymphocytes, CD19+ CD5- lymphocytosis, and elevated IgM.
- Typically indolent, but can present with significant splenomegaly.
Purpose of the Study:
- To present a case of PPBL with massive splenomegaly.
- To discuss the diagnostic challenges and management of PPBL.
- To emphasize the importance of comprehensive analysis to avoid misdiagnosis.
Main Methods:
- Case presentation of a young male with massive splenomegaly.
- Review of diagnostic workup including flow cytometry and molecular analysis.
- Discussion of surgical management and its implications.
Main Results:
- The patient presented with massive splenomegaly, mimicking splenic lymphoma.
- Diagnostic evaluation was crucial to differentiate PPBL from lymphoma.
- Surgical intervention was performed for symptomatic relief and diagnosis.
Conclusions:
- Massive splenomegaly in PPBL can be diagnostically challenging, often mimicking lymphoma.
- A thorough diagnostic approach including molecular and flow cytometry analysis is essential.
- Careful management is required to prevent misdiagnosis and ensure appropriate treatment.
