T‐cell‐rich B‐cell lymphoma of the spleen presenting with severe hypersplenism

We report a 19‐year‐old woman who was presented with B‐symptoms, massive splenomegaly, hepatomegaly and hypersplenism. She underwent diagnostic/therapeutic splenectomy. Microscopically, the spleen showed a vaguely micronodular and diffuse proliferation of lymphoid cells in the white pulp that also involved the red pulp. On immunohistochemical staining, this proliferation consisted predominantly of CD3⁺, CD7⁺ small T cells with the presence of a minor populat?on of CD15^?,CD30^?, CD20⁺ large atypical B cells. A liver biopsy also showed a similar morphology to that seen in the spleen. After splenectomy, only the pancytopenia improved. A combined immunochemotherapy regimen (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) was utilized, which resulted in a complete remission.