Splenic lymphoma with villous lymphocytes. A laboratory review of six cases

In this study we have reviewed six cases of SLVL presenting over a period of seven years. A meticulous workup of all these cases was carried out including TRAP, immunophenotyping and electron microscopic (EM) studies. Our study shows that abdominal distention and splenomegaly are the commonest symptom and sign in SLVL as seen in 5 out of 6 patients. Anemia, moderate leucocytosis and the lymphocytes with villous projections ranging from 10 percent -43 percent were seen. Immunologically the cells from all cases expressed B-cell antigen (CD19) and light chain restriction (k-4 cases and gamma-2 cases) and moderate to strong intensity for Surface Immunoglobulin (SmIg). Majority of the cases were positive for CD5, FMC7, CD11c and CD25. DBA44 was positive in a cases where it could be done and negative for CD23. In this study we have not been able to demonstrate a distinct immunophenotypic profile for SLVL. However, the ultrastructural features were consistant and were diagnostic. Hence, we conclude that multiparameter studies including morphology, immunological profile and ultrastructural features help in the diagnosis of SLVL.