Clinicopathologic features of splenic diffuse red pulp small B-cell lymphoma

CHEN Ding-bao; SHEN Dan-hua; WANG Ying; SONG Qiu-jing; JIANG Qian; FANG Xin-zhi

doi:10.3969/j.issn.1007-8096.2017.11.009

Abstract：Purpose To study the clinicopathologic features,diagnosis and differential diagnosis of splenic diffuse red pulp small B-cell lymphoma (SDRPSBL).Methods Two cases of SDRPSBL were selected from Peking University People's Hospital from 2014 to 2016.According to WHO classification of tumours of haematopoietic and lymphoid tissues in 2008 and updated of WHO classification in 2016,the cases were studied by microscopy,immunohistochemistry and clinical examinitions,with review of the related literature.Results Case 1 was female and 51 years old,presented as anemia and lymphocytopenia.Case 2 was male and 40 years old,presented as lymphocytosis and elevation of LDH.Both cases presented as elevation of WBC counting and splenomegaly,and splenectomy were performed.Microscopically,the structure of red pulp and white pulp of spleen was unclear,with intrasinusoidal infiltration of small to medium-sized lymphocytes in the spleen.Widespread bleeding and lake of blood can be seen.Immunophenotype showed that the tumor cells were positive for CD20,PAXS,and negative for CD3,CD5,CD23,cyclinD1,CD38,CD25;the proliferative index were 5％ and 10％,respectively.Follow-up of Case 1 was lost,and general condition of Case 2 was good.Conclusion SDRPSBL is a distinct and rare entity,which is characterized by small to medium-sized lymphocytes infiltration in splenic red pulp.Differetial diagnosis from other small B cell lymphomas of the spleen is necessary.