B-Type Large-Cell Primary Splenic Lymphoma with Massive Involvement of the Red Pulp

Salgado, Camino; Feliú, Evarist; Montserrat, Emili; Villamor, Neus; Ordï, Jaume; Aguilar, Josep Ll.; Vives‐Corrons, Joan‐Lluis; Rozmán, C

doi:10.1159/000204483

Cited by 10 publications

(4 citation statements)

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“…Moreover, we observed lymphoma cell surface expression of the CD5 antigen in eight of the ten patients (80%) [8,10,12], including four of our original six patients. Low intensity of the lymphoma cell CD5 antigen might not be detectable by immunohistochemistry (Tables 3 and 6).…”

Section: Discussionmentioning

confidence: 86%

“…Kuratsune et al [4] reported the first case of DLBCL that non-cohesively proliferated into the splenic red pulp and demonstrated clinicopathological features of malignant histiocytosis. Since their initial report, only 18 cases of DLBCLs non-cohesively infiltrating the splenic red pulp have been reported [4][5][6][7][8][9][10][11][12][13]. These reports support the existence of DLBCL manifesting in the splenic red pulp (DLBCLRP).…”

Section: Introductionmentioning

confidence: 99%

“…To clarify the features of this rare lymphoma, we describe six new cases of DLBCLRP and present an analysis of the clinicopathological features of an additional 18 previously reported cases [4][5][6][7][8][9][10][11][12][13]. After reviewing the data, we developed seven characteristic features of DLBCLRP.…”

Section: Introductionmentioning

confidence: 99%

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Primary splenic diffuse large B-cell lymphoma manifesting in red pulp

et al. 2008

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We evaluated six cases of diffuse large B-cell lymphoma (DLBCL) involving the red pulp of the spleen. All had B symptoms and an aggressive clinical course. The lymphoma cells proliferated diffusely and non-cohesively in the cords of the red pulp. The lymphoma involved the bone marrow in four of the five patients and the liver in all four of the patients examined. However, lymph node (LN) involvement was rare at presentation, and systemic LN involvement was not observed even in the terminal phase. The lymphoma cells infiltrated the intrasinusoidal/intravascular and interstitial spaces of the involved tissues and were detected in the peripheral blood in two of the six patients. CD5-expressing lymphoma cells were detected in four of the five patients examined. Because these cases had some unique clinical features and occurred in distinct splenic sites, we proposed that primary splenic DLBCL manifesting in red pulp is a distinct clinicopathological entity.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Primary splenic diffuse large B-cell lymphoma manifesting in red pulp

et al. 2008

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“…[12][13][14] These include a purportedly distinct variant of intrasinusoidal splenic LBCL occurring primarily in Asians which is associated with histocytic proliferation, prominent hemophagocytosis, and aggressive behavior. [15][16][17] The nature of these latter cases remains unclear and it has been speculated that some may represent a variant of intravascular LBCL.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma with distinctive patterns of splenic and bone marrow involvement: clinicopathologic features of two cases

2005

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Two unusual cases of large B-cell lymphoma with predominant splenic and bone marrow (BM) involvement and similar clinical and histopathologic features are described. Both patients presented with nonspecific constitutional symptoms, unexplained cytopenias, and splenomegaly. Splenectomy revealed diffuse red pulp involvement by large B-cell lymphoma. The perisplenic lymph nodes were also involved diffusely with effacement of normal nodal architecture, excluding a diagnosis of intravascular large B-cell lymphoma. BM biopsies revealed striking erythroid hyperplasia without overt morphologic evidence of involvement by lymphoma. Immunoperoxidase staining of the marrow biopsies with antibodies to CD20 and erythroidassociated antigens revealed involvement by large B-cell lymphoma morphologically resembling the early pronormoblasts. In both cases there was prominent, but not exclusive, intravascular/intrasinusoidal lymphomatous marrow infiltration. These cases represent an unusual variant of large B-cell lymphoma with distinctive patterns of splenic and BM involvement. Furthermore, they underscore the difficulties in identifying intrasinusoidal marrow infiltration by lymphoma in H&E-stained biopsy slides and demonstrate that this pattern of marrow infiltration may be seen in cases of large B-cell lymphoma distinct from the intravascular variant. Keywords: diffuse large B-cell lymphoma; intravascular lymphoma; spleen; bone marrow; erythroid hyperplasia; non-Hodgkin lymphoma Diffuse large B-cell lymphoma (LBCL) can involve nodal or extranodal sites; however, initial presentation in the spleen occurs infrequently. 1 Typically when diffuse LBCL involves the spleen it forms discrete tumoral masses within the splenic parenchyma. 2 A recent report detailed other less common patterns of splenic involvement by LBCL including diffuse infiltration of the splenic red pulp. 3 The clinicopathologic features of diffuse LBCL with these unusual patterns of splenic involvement have yet to be fully elucidated. Described herein are the distinctive clinical and histopathologic features of two cases of splenic LBCL with diffuse red pulp infiltration and concurrent involvement of lymph nodes and bone marrow (BM). These cases had strikingly similar clinical presentations chiefly characterized by dyspnea, unexplained cytopenias, and splenomegaly. In both instances, splenectomy performed to alleviate the cytopenias revealed diffuse, homogeneous involvement of the splenic red pulp by diffuse LBCL. Although the pattern of splenic red pulp involvement and the clinical features raised the possibility of intravascular LBCL, in both cases there was parenchymal involvement of splenic hilar lymph nodes, excluding this diagnosis as defined by the most recent WHO criteria. 4 Furthermore, both cases had prominent BM involvement by lymphoma, which was difficult to detect by routine morphologic evaluation of hematoxylin and eosin (H&E)-stained biopsy slides. This difficulty was due both to the presence of prominent erythroid hyperplasia as well as a predominan...

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