[Splenic lymphoma with villous lymphocytes and complex chromosomal abnormality]

We report a 70-year-old Japanese man who had splenic lymphoma with villous lymphocytes and a complex chromosomal abnormality. No monoclonal gammopathy was present. The peripheral blood film showed lymphocytes with thin and short villi arising from one or two poles of the cells. These cells were negative for tartrate-resistant acid phosphatase stain. Immunophenotyping of peripheral blood lymphocytes showed moderate to strong expression of surface membrane IgM, IgD, IgA, and lambda as well as CD19, CD20, CD21, CD24, and HLA-DR. In addition, there was weak CD5, CD22, and CD25 expression, but no CD10, CD11c, CD23, CD38, or B-ly-7 expression. All 20 metaphases obtained from peripheral blood cells cultured for 5 days with lipopolysaccharide showed an abnormal karyotype: 47, XY, +der(3) t(3; 13) (q26; q12) inv(3) (?), t(7; 14), (q21; q11), der(13) t(3; 13) (q26; q12). Our patient followed a relatively benign clinical course and splenectomy was not performed.