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Splenic lymphoma with circulating villous lymphocytes
Journal of Clinical Pathology
|June 1, 1995
Summary
This case report details splenic lymphoma with villous lymphocytes (SLVL) in a patient with a family history of chronic lymphocytic leukemia. Unusual findings included high lymphocytosis and specific lymphocyte characteristics, highlighting the need for thorough diagnostic analysis.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Splenic lymphoma with villous lymphocytes (SLVL) is a rare B-cell lymphoproliferative disorder.
- A family history of chronic lymphocytic leukemia (CLL) was noted in this patient.
- Small B-cell lymphoproliferative disorders require careful diagnostic evaluation.
Observation:
- A 56-year-old female presented with unusual features of SLVL.
- Marked lymphocytosis (up to 224 x 10(9)/l) and lymphocyte clumping in EDTA blood were observed.
- Neoplastic B-cells exhibited specific immunophenotypes (CD19+, CD20+, CD22+, IgM+, lambda+).
Findings:
- Spleen examination revealed nodular B-cell infiltrates in the white pulp.
- Electron microscopy showed peripheral blood lymphocytes with polar cytoplasmic processes.
- The neoplastic cells were negative for CD5 and CD10, aiding in differential diagnosis.
Implications:
- This case underscores the importance of integrating morphology and immunophenotyping for accurate diagnosis of SLVL.
- Detailed analysis is crucial for differentiating SLVL from other small B-cell lymphoproliferative disorders.
- Understanding rare presentations of SLVL contributes to improved diagnostic strategies.