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Reactive follicular hyperplasia, comp. with changes in ITP (3519) » Slika 1.jpg
Filename: Slika 1.jpg
[Reactive follicular hyperplasia, comp. with changes in ITP]
We present a new case of the spleen lesion in a 40-year-old Bosnian female that clinically presented as a thrombocytopenia.  
Surgery was performed and her spleen was removed.  
On gross examination, a 11x9 cm large spleen showed areas of micronodular pattern. Hilar lymph node was unremarkable.  
Microscopic analysis revealed the presence of a central dark zone withine the white pulp, composed of small lymphocytes. The white pulp was surrounded by marginal and mantle zone. The red pulp contained dilated sinuses filled with moderately large lymphocytes with monocytoid features.  
Immunohistochemistry:  
Spleen: CD3 positive (predominantly in the red pulp and marginal zone), CD5 (predominantly positive in marginal and mantle zone and single cells within the red pulp), CD43 (predominantly diffuse positivity), CD45RA (B-lymphocytes), Bcl-2 (positive in marginal and mantle zone as well as in sinuses).  
Hilar lymph node: Preserved normal architecture, expansion of marginal and mantle zone of secondary follicles. CD3 positive predominantly in interfollicular areas; CD5 positive in interfollicular areas and sporadically positive within the secondary follicles; CD43 - the same as CD5; CD45RA diffusely positive; Bcl-2 positive in mantle and marginal zone as well as in interfollicular areas.  
Clinical diagnosis: Essential thrombocytopenia  
Histipathological diagnosis: Splenic marginal zone lymphoma (SMZL)?  
Please, give your opinion!
Sender: semir
2007-08-10 10:17
INCTR - EBMWG Hematopathology Online

Last modified: 2007-08-10 10:17:55