Jain D, Sharma M C, Sarkar C, Suri V, Garg A, Mahapatra A K, Kumar L
Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.
J Neurooncol. 2008 Jun;88(2):237-41. doi: 10.1007/s11060-008-9561-1.
The authors report an unusual case of hepatosplenic T-cell lymphoma in a 41-year-old male patient. He presented initially with low grade fever, hepatosplenomegaly and pancytopenia. Splenectomy was done which showed infiltration of red pulp by monomorphic lymphocytes. Liver was also infiltrated with similar cells. A provisional diagnosis of hairy cell leukemia was made. Subsequently, after 6 months he was found to have a sellar mass, which on microscopy revealed lymphoma cells. These cells were positive for leukocyte common antigen and T-cell markers. Finally, based on overall clinical, histomorphological and immunophenotypic features, a diagnosis of hepatosplenic T-cell lymphoma, possibly gamma delta type, involving pituitary gland was established. On follow up, this patient showed evidence of bone marrow involvement and died after 1.5-year of diagnosis. This case highlights the involvement of rare site by a rare lymphoma and should be kept in mind in the differential diagnoses of pituitary tumors.
作者报告了一例41岁男性患者的罕见肝脾T细胞淋巴瘤病例。他最初表现为低热、肝脾肿大和全血细胞减少。进行了脾切除术，结果显示红髓被单形性淋巴细胞浸润。肝脏也被类似细胞浸润。初步诊断为毛细胞白血病。随后，6个月后发现他有鞍区肿物，显微镜检查显示为淋巴瘤细胞。这些细胞白细胞共同抗原和T细胞标志物呈阳性。最后，根据总体临床、组织形态学和免疫表型特征，确诊为累及垂体的肝脾T细胞淋巴瘤，可能为γδ型。随访时，该患者出现骨髓受累证据，诊断后1.5年死亡。该病例突出了罕见淋巴瘤累及罕见部位的情况，在垂体肿瘤的鉴别诊断中应予以考虑。
