Splenic Lymphoma with an Incidental Hemolytic Anemia: A Rare Association.

Splenic lymphoma with villous lymphocytes (SLVL) is a rare malignancy that comprises less than 1% of lymphoid neoplasms, characterized by the presence of small atypical lymphocytes in the peripheral blood and bone marrow and splenic infiltration in the white and red pulp. It must be distinguished from other chronic lymphoproliferative disorders that present with a similar clinical and hematological profile. Here, we report a case of SLVL in a 60-year-old male with leukocytosis, massive splenomegaly, and relatively few small sized leukemic cells presenting with a Coomb’s positive hemolytic anemia. It was initially diagnosed as chronic lymphocytic leukemia. The immunophenotyping studies and marrow examination indicated a diagnosis of SLVL. This case highlights the diagnostic pitfalls associated with this rare disorder.

Chronic myeloid leukemia with hyperdiploidy: A case report with review of literature.

Chronic myeloid leukemia (CML) is a common marrow stem cell neoplasm characterized by the presence of the Philadelphia (Ph) chromosome in more than 90% of patients. Studies have shown that CML can be associated with various other cytogenetic abnormalities. 5-10% of these cases can show complex translocations involving other chromosomes in addition to Ph chromosome. Here, we report a Ph-positive CML patient with a hyperdiploid karyotype who presented clinically in chronic phase but progressed to blast crisis in spite of treatment with Imatinib. This case highlights the significance of cytogenetic abnormalities on the prognosis in CML.

Rosette formation in non Hodgkin's lymphoma in the bone marrow--a case report.

This is a case report of rosette formation in non-Hodgkin's lymphoma in the bone marrow. A 66 year old female on treatment for metastatic papillary carcinoma thyroid and non-Hodgkin's lymphoma of the nodular small cleaved cell type was found to have bone marrow infiltration by a low grade B cell lymphoma. Bone marrow aspirate, imprint and trephine biopsy showed rosettes of the abnormal lymphoid cells. The associations of papillary carcinoma thyroid, hyperglobulinemia and retroperitoneal fibrosis in this case which explain the histogenesis of rosette formation are discussed.