Splenic marginal zone lymphoma uncovered after a 10-year follow up as anemia of unknown cause

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  • 原因不明の貧血として10年間経過観察したのち診断し得た脾臓辺縁帯リンパ腫
  • 症例報告 第4回日本血液学会関東甲信越地方会 奨励賞 原因不明の貧血として10年間経過観察したのち診断し得た脾臓辺縁帯リンパ腫
  • ショウレイ ホウコク ダイ4カイ ニホン ケツエキ ガッカイ カントウ コウシンエツチホウカイ ショウレイショウ ゲンイン フメイ ノ ヒンケツ ト シテ 10ネンカン ケイカ カンサツ シタ ノチ シンダン シエタ ヒゾウ ヘンエンタイ リンパシュ

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Abstract

<p>A 75-year-old man was referred to our hospital for evaluation of persistent anemia. Despite repeated diagnostic tests, including bone marrow aspiration, the cause of his anemia remained unknown. On each occasion, computed tomography had revealed neither swollen lymph nodes nor splenomegaly. After a 10-year follow-up period, he was admitted with general fatigue and had developed splenomegaly as well as the anemia. Bone marrow biopsy revealed increased abnormal lymphocytes with short villi that were positive for CD11c, CD19, CD20, and kappa chain, but not for CD5, CD10, CD23, or cyclin D1, according to flow cytometry. The bone marrow biopsy sample showed nodular proliferation of small to medium-sized abnormal lymphocytes. Based on these findings, the patient was diagnosed as having splenic marginal zone lymphoma, a rare indolent B-cell neoplasm. Although his splenomegaly diminished after eight cycles of weekly rituximab monotherapy, the anemia did not improve, and abnormal lymphocytes remained detectable in his bone marrow. The patient was then treated with bendamustine monotherapy for six cycles, after which the anemia resolved, and he has since been in good condition. Although rare, it is important to consider splenic marginal zone lymphoma during the differential diagnosis of patients with a long history of anemia of unknown cause.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 58 (1), 9-14, 2017

    The Japanese Society of Hematology

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