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NJBMS - Volume 9, Issue 3, January - March 2019

Pages: 134-137
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Splenic Marzinal Zone Lymphoma: A Rare Case Report

Author: Thamilselvi R , Anbu Lenin Kulandaivel , GowriSankar Ramalingam

Category: Pathology


Background: The term Splenic marginal zone lymphoma [SMZL] was first coined by schmid and colleagues in 1992.Splenic marginal zone lymphomas are B-cell NHL with distinct clinical, morphological and immunophenotypical profile. These are rare B-cell neoplasms which constitute for less than 2% of lymphoid neoplasms usually affecting older individual between ages of 40-60 years with male preponderance. Patients usually present with moderate to marked splenomegaly with involvement of the bone marrow. Lymph node involvement is extremely uncommon. Peripheral smear examination may demonstrate atypical villous lymphocytes.

Case report: A 60 year male presented with abdominal fullness and dragging sensation over left side of the abdomen for 3months.Patient also had symptoms of anaemia. There was no history of weight loss or loss of appetite. On clinical examination he was found to have massive splenomegaly which was subsequently confirmed by abdominal ultrasonography. There was no evidence of peripheral lymphadenopathy. On investigating patient had 10.1g/dL of haemoglobin, moderate leucocytosis - 32,500 cells/uL with lymphocytic predominance [81%] and normal platelet count – 1.80Lcells/uL. After peripheral smear examination diagnosis of chronic lymphocytic leukemia was made and flow cytometric analysis was suggested. Flow cytometric findings were consistent with Splenic marginal zone lymphoma. Patient also underwent bone marrow examination and splenectomy which showed features of splenic marginal zone lymphoma. This case is being presented for its rarity and unique clinical and morphological presentation.

Keywords: NHL, Splenic marginal zone lymphoma, Massive splenomegaly, Leucocytosis, Flowcytometry.

DOI: 10.31975/NJBMS.2019.9305