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Follicular lymphoma presenting with marked splenomegaly: report of three cases
Authors:Koiso Hiromi  Yokohama Akihiko  Mitsui Takeki  Saitoh Takayuki  Handa Hiroshi  Murakami Hirokazu  Hirato Junko  Kojima Masaru  Nojima Yoshihisa  Tsukamoto Norifumi
Affiliation:Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Gunma University Hospital, Maebashi, Japan.
Abstract:Marked splenomegaly as the main presenting sign in follicular lymphoma (FL) is rare. The clinical and morphologic findings of 3 FL patients with massive splenomegaly and slight or no lymphadenopathy are presented. All cases had massive splenomegaly, and 2 had minimal peripheral lymphadenopathy with bone marrow infiltration, which is the major involved site besides the spleen. Histologically, various sizes of micronodules, composed of medium-sized centrocytes, were present in the white pulp in 2 cases in whom splenectomy was performed. The other case was complicated by nephrotic syndrome and showed aggregates of packed small lymphocytes in the spleen and renal parenchyma. Tumor cells were positive for CD10, CD20, bcl-2, and bcl-6. Since these cases are clinically similar to splenic marginal zone lymphoma, recognition of this disease and selection of the appropriate therapy are needed.
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