DOI: 10.36347/sasjs.2020.v06i02.013

Pages: 77-80

Splenic marginal zone cell lymphoma (LZMS) is a very rare B lymphoma; Representing 2% of all NHL, this lymphoma invades the spleen, perisplenic nodes and frequently the marrow, which can be a source of diagnostic traps. Patient aged 65, hospitalized for the exploration of a splenic tumor mass confirmed by a computed tomography (CT) scan. The biological assessment finds an inflammatory SD + high LDH. A splenectomy was performed. The microscopic study of the operating room showed a diffuse lymphomatous proliferation with small cells, with labeling by CD20. CD 5 and CD 43 are negative. The diagnosis of LZMS was accepted. LZMS affects the subject over the age of 50, usually characterized by the presence of a large splenomegaly without lymphadenopathy. The hemogram shows in three quarters of the cases the inconsistent presence of villous lymphocytes. The diagnosis is essentially anatomopathological, it shows a constant nodular or sometimes diffuse attack of the white pulp of the splenic parenchyma. The tumor cells are small, expressing the B lymphoid markers: CD19, CD20, CD22, CD79. They are negative for CD5, CD10, cyclinde D1 and CD43. No specific cytogenetic abnormality of LZMS was identified. It is an indolent lymphoma, the treatment of which has not yet been codified, depends on prognostic factors. Death is linked to the risk of transformation to large cell lymphoma.