Abstract
AIMS: To determine the cause for massive splenomegaly. MATERIALS AND METHODS: Splenectomy was done and sections given from cut surface. They were stained with haemotoxylin & eosin and microscopically analysed. Immunohistochemical study was done for a panel of antibodies including CD5, CD10, CD20, bcl-2 & cyclin D1. RESULTS: Microscopy showed effacement of the normal architecture along with a nodular architecture in the white pulp with small lymphocytes surrounded by medium to large lymphoid cells with dispersed chromatin and abundant pale cytoplasm which resembled the marginal zone cells. Immunohistochemical study showed positivity for CD20 and bcl -2. It was negative for CD5, CD10 and Cyclin D1. Considering all the findings a diagnosis of Splenic Marginal Zone Lymphoma (SMZL) was made. CONCLUSION: In this case, clinically lymphoma was not suspected, as splenomegaly was the only finding. Patient was thoroughly investigated for various causes of splenomegaly but only histopathological evaluation of spleen along with IHC study was diagnostic.
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