[T-lymphocyte-rich large B-cell lymphoma--case report]

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Hepatosplenomegaly and hepatic failure can indicate various systemic diseases.
• Distinguishing between malignant infiltrates and reactive changes is crucial for diagnosis.

Observation:

• A 60-year-old male patient presented with enlarged liver and spleen, along with signs of liver dysfunction.
• Histological examination of liver and spleen revealed nodular infiltrates.
• These infiltrates contained large atypical cells resembling Sternberg-Reed cells and numerous T-lymphocytes.

Findings:

• The atypical large cells were identified as B-cell lineage, confirmed by CD20 positivity.
• Crucially, these cells lacked CD15 and CD30 expression, antigens typically found on Sternberg-Reed cells.
• This immunophenotype suggests a B-cell neoplasm distinct from classical Hodgkin lymphoma.

Implications:

• The findings highlight a case of atypical B-cell infiltrates in the liver and spleen.
• This case emphasizes the importance of comprehensive immunophenotyping for accurate diagnosis of hematologic malignancies.
• Further investigation may be warranted to determine the specific B-cell subtype and guide treatment.