College of American Pathologists

2011 — September Case of the Month

Posted September 20, 2011


CAP Foundation September 2011 Online Case of the Month

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An 85-year-old woman presented with weakness and abdominal pain. Evaluation revealed pancytopenia, peripheral blood lymphocytosis, and massive splenomegaly. A splenectomy was performed. The 2,227 g spleen had cut surfaces that were dark red-brown and homogeneous. Flow cytometric immunophenotyping revealed a CD45 bright lymphoid population that expressed B cell antigens, FMC7, CD11c, and CD103. CD5, CD10, and CD23 were not expressed.

The master list with the correct answer

  • Chronic myeloid leukemia
  • Hairy cell leukemia
  • Large B-cell lymphoma
  • Mantle cell lymphoma
  • Small lymphocytic lymphoma/chronic
     lymphocytic leukemia

  • Splenic marginal zone lymphoma

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  • Appropriate diagnosis
  • Critique
  • References

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