Splenic B cell lymphoma with circulating villous lymphocytes: differential diagnosis of B cell leukaemias with large spleens.

Melo, JV; Hegde, U. M.; Parreira, A; Thompson, Irene M. Ghobrial; Lampert, Irvin A.; Catovsky, Daniel

doi:10.1136/jcp.40.6.642

Cited by 174 publications

(86 citation statements)

References 6 publications

(2 reference statements)

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“…SMZBCL may express circulating monocytoid B cells, with or without microvilli, and a variable amount of lymphocytes which closely resemble those of SLVL. Bone marrow involvement in the absence of significant lymphadenopathy is also commonly seen at presentation (Melo et al, 1987).…”

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confidence: 99%

Frequent involvement of chromosomes 1, 3, 7 and 8 in splenic marginal zone B‐cell lymphoma

Solé¹,

Woessner²,

Florensa³

et al. 1997

Br J Haematol

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Summary.We have studied 19 cases of splenic marginal zone B-cell lymphoma (SMZBCL) combining cytological features, conventional cytogenetics, and in situ hybridization (ISH) techniques.A clonal chromosome abnormality was found in 11/19 patients (58%). The more frequent recurrent abnormalities were: del(3), del (7q), and involvement of chromosomes 1, 3, 7 and 8. No patient showed the translocation t(11;14)(q13;q32). An outstanding finding was the low incidence of trisomy 3 (36%) compared to patients with MALT lymphoma. These findings support the interpretation that SMZBCL is a distinct lymphoproliferative disorder.

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confidence: 99%

Frequent involvement of chromosomes 1, 3, 7 and 8 in splenic marginal zone B‐cell lymphoma

Solé¹,

Woessner²,

Florensa³

et al. 1997

Br J Haematol

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“…[1][2][3][4] The lymphoma infiltrates the white pulp of the spleen. 5 SMZL expresses pan B-cell markers such as CD19, CD20, and CD22 as well as surface IgM and IgD.…”

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confidence: 99%

Splenic Marginal Zone Lymphoma with Villous Lymphocytes Shows On-Going Immunoglobulin Gene Mutations

Tierens¹,

Delabie²,

Małecka³

et al. 2003

The American Journal of Pathology

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“…The diagnosis of SLVL may be missed in these cases, and may be misdiagnosed as any of the other chronic lymphoproliferative disorders. 1,3 However, bone marrow examination complemented by immunophenotyping can identify such cases. 3 This approach was helpful in our third case.…”

Section: Discussionmentioning

confidence: 99%

“…3 Villous lymphocytes range between 5% and 90% in blood. 1,3 Finding of villous lymphocytes is particularly difficult in cases with absence of lymphocytosis. The diagnosis of SLVL may be missed in these cases, and may be misdiagnosed as any of the other chronic lymphoproliferative disorders.…”

Section: Discussionmentioning

confidence: 99%

Splenic Lymphoma with Villous Lymphocytes: Report of Three Cases

et al. 2000

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Splenic lymphoma with villous lymphocytes (SLVL) is a recently recognized entity among chronic B lymphoproliferative disorders. It has a distinct clinical, morphological and immunophenotypic pattern and was previously described under a variety of designations. SLVL can be misdiagnosed as chronic lymphocytic leukemia (CLL), prolymphocytic leukemia (PLL), or hairy cell leukemia (HCL). Characteristically, these cells are CD5-, CD10-, CD23-, CD25-, HC2-, FMC7+, CD19+, CD22+ and strongly positive surface Ig (SmIg). Patients with SLVL are elderly (usually males) with splenomegaly and lymphocytosis (<100x 10 9 /L), with many villous lymphocytes, IgM monoclonal gammopathy in some, and usually have a benign course. We describe three cases of SLVL from the Eastern Province of Saudi Arabia. To our knowledge, this is the first well-documented report of SLVL from Saudi Arabia. Case Reports Case 1A 75-year-old Saudi male was first admitted to our hospital eight years ago. At that time, he had ischemic heart disease with inferior wall myocardial infarction and NIDDM. He had no splenomegaly and his CBC was normal. The patient was also known to have obstructive uropathy with hydronephrosis due to ureteric calculi, and had had an operation for this two years before that time. Four years ago, splenomegaly and lymphocytosis were noticed (Table 1), for which a diagnosis of CLL was made. Approximately three years ago, one of the authors (MIQ) noticed some villous lymphocytes in his blood film, and the patient was recalled for examination and evaluation. Examination showed a huge splenomegaly crossing the umbilicus. No lymphadenopathy was present. Ultrasonography showed the spleen was 20 cm long, the splenic vein was 1.4 cm, and there was bilateral hydronephrosis. Hemogram findings are shown in Table 1. The blood film showed varied forms of lymphoid cells. Some were large with abundant paleblue cytoplasm. The nuclei had clumped chromatin and prominent nucleolus in some. Some lymphocytes were binucleated and an occasional one was plasmacytoid. Several cells had fuzzy cytoplasm. Lobulated nucleus was seen in a few cells ( Figure 1A). There was another population of lymphoid cells which were comparatively small to medium in size but had short villi. These villi were either at one side (polar) (Figure 1B), or were located throughout the cell border. The percentage of such cells varied in different slides and on different occasions, but were between 10% and 30%. Some of the lymphoid cells were normal-looking small lymphocytes. A few smudge cells were also seen. The results of immunophenotype of blood lymphocytes using Becton Dickinson FAC SCAN are shown in Table 2. Serum protein electrophoresis showed no monoclonal gammopathy. Serum IgG/M/A were normal. Serum creatinine was slightly raised (1.99 mg/dL) and uric acid was 8.6 mg/dL. Bone marrow findings are shown in Table 3. The patient has shown a progression of the disease over three years of follow-up, and splenectomy is being considered.

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Splenic B cell lymphoma with circulating villous lymphocytes: differential diagnosis of B cell leukaemias with large spleens.

Cited by 174 publications

References 6 publications

Frequent involvement of chromosomes 1, 3, 7 and 8 in splenic marginal zone B‐cell lymphoma

Frequent involvement of chromosomes 1, 3, 7 and 8 in splenic marginal zone B‐cell lymphoma

Splenic Marginal Zone Lymphoma with Villous Lymphocytes Shows On-Going Immunoglobulin Gene Mutations

Splenic Lymphoma with Villous Lymphocytes: Report of Three Cases

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