Primary Isolated Bone Marrow Diffuse Large B-cell Lymphoma with Hemolytic Anemia as the First Manifestation

Abstract

Primary isolated bone marrow disease as a presenting feature of diffuse large B-cell lymphoma is very rare. We describe the first Korean case of isolated bone marrow diffuse large B-cell lymphoma with hemolytic anemia as the first manifestation. A32-year-old man was admitted to our hospital presenting with fever and hematuria. He had severe anemia and high lactate dehydrogenase activity. His peripheral blood smear and laboratory findings were suggestive of intravascular hemolytic anemia. The bone marrow biopsy revealed involvement with diffuse large B-cell lymphoma. A computed tomographic scan showed splenomegaly, but no lymphadenopathy. Our case shared some clinical features with the Asian variant of intravascular B-cell lymphoma, but there was infrequent involvement of the sinusoids of lymphoma cells and no hemophagocytosis. Our patient was treated with R-CHOP regimen for six cycles and he is in remission after autologous peripheral blood stem cell transplantation.

Primary Bone Marrow B-Cell Lymphoma: Correlation of Results of Flow Cytometry and Morphological Findings

“…B-cell NHL is the single largest category, comprising 90% of total NHL cases [1]. Secondary involvement of malignant lymphomas in bone marrow is relatively common but primary occurrence of bone marrow disease as presenting feature of NHL is quite rare [2,3]. Primary bone marrow lymphoma (PBML) usually presents with cytopenias or fever of unknown origin raised LDH and heterogeneous histology [4].…”