Splenic lymphoma with villous lymphocytes: case report

Abstract

We present the case of malignant Non-Hodgkin splenic lymphoma with villous lymphocytes regarded as atypical chronic lymphoid leukemia. This was a 62 years old male patient admitted in the Haematologic Department of Brazzaville Teaching Hospital for an enlarged spleen, anaemia and lymphocytosis. The initial abdominal CT noticed a homogenous splenomegaly and a large retroperitoneal tumour mass measuring 148 X 101mm. The initial count blood cell revealed a lymphocytosis with a lymphocyte count at 82 Giga/l, severe anaemia with a haemoglobin rate at 4.2g/dl, platelet count at 68 Giga/l. Peripheral smear examination showed irregular lymphoid cells with a homogenous distribution, condensed chromatin corresponding to villous lymphocytes. Immunophenotyping showed B lymphoid monotypic population cells positive for CD19, CD 20, and FMC7, moderately positive for CD23 and negative for CD5, CD43 and CD 79b. Therapeutically, combination chemotherapy RCVAD (Rituximab, Vincristin, Daunorubicin, Dexamethasone) give good clinical and haematological response. This report illustrates the need for excellent interdisciplinary collaboration and the interest of the cytology and immunophenotyping in the lymphoid proliferation management.