Imashuku Shinsaku, Kudo Naoko, Kubo Kagekatsu, Saigo Katsuyasu
Division of Hematology, Takasagoseibu Hospital, Takasago 676-0812, Japan.
Division of Internal Medicine, Takasagoseibu Hospital, Takasago 676-0812, Japan.
Case Rep Hematol. 2015;2015:181263. doi: 10.1155/2015/181263. Epub 2015 Oct 8.
In splenic marginal zone lymphoma (SMZL), there are cases that cannot accurately be classified as such because of overlapping morphologic and/or immunophenotypic features. We report here a 76-year-old Japanese female, who showed leukemic B-cell lymphoproliferative disease possessing characteristic features identified for SMZL. The patient was leukemic with white blood cell counts 49,400/µL (abnormal cells, 78.5%) and neoplastic cells were characterized by aberrant expression of myeloid markers with CD19(+)CD13(+) (64.2%) and CD20(+)CD11c(+) (25.1%). Considering her history of previous chemotherapy and systemic leukemic phase of the disease, we treated the patient without performing splenectomy, with successful use of a combination of rituximab/bendamustine hydrochloride and of rituximab/cladribine. The patient has been in a complete remission longer than 44 months, with no detectable M-protein.
在脾边缘区淋巴瘤（SMZL）中，由于形态学和/或免疫表型特征重叠，有些病例无法准确归类为此类疾病。我们在此报告一名76岁的日本女性，其表现为具有SMZL特征性表现的白血病性B细胞淋巴增殖性疾病。该患者患有白血病，白细胞计数为49,400/µL（异常细胞占78.5%），肿瘤细胞的特征是髓系标志物异常表达，CD19(+)CD13(+)（64.2%）和CD20(+)CD11c(+)（25.1%）。考虑到她既往的化疗史和疾病的全身性白血病期，我们未进行脾切除术对患者进行治疗，成功使用了利妥昔单抗/盐酸苯达莫司汀以及利妥昔单抗/克拉屈滨联合治疗。该患者已完全缓解超过44个月，未检测到M蛋白。
