Splenic lymphoma with villous lymphocytes; a case report with review of literature

Splenic lymphoma with villous lymphocytes (SLVL) is a rare low-grade B cell non-hodgkin's lymphoma with distinct clinical and morphologic features. We report a case in a 55 year old man with the diagnosis of Chronic lymphocytic leukemia. On examination patient had no peripheral lymphadenopathy, but had splenomegaly of 2cm below costal margin. Laboratory investigations revealed WBC count 27.9x10 9 /l with an absolute lymphocyte count of 22.3x10 9 /l. Peripheral smear examination showed 80% lymphoid cells, 36% of which showed villous morphology, R-O nucleus, opened up chromatin and no nucleolus. Bone marrow aspirate and biopsy also showed involvement by these villous lymphocytes. These cells were negative for all cytochemical stains including tartrate-resistant acid phosphatase. On flow cytometric immuno-phenotyping these lymphoid cells were highly positive for CD19, CD20, FMC-7, moderately positive for CD10 and negative for CD5, CD23, CD25, CD103 and surface immunoglobulins (SIg) . Based on these findings a diagnosis of SLVL was suggested