MEETING No. 29, CAMAIORE (LUCCA), MARCH 17th, 2001

Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Case 1

"SPLENOMEGALY"
G. MARCHETTI - S. Chiara Hospital - Pisa
(pict. by dr. Faravelli)

Clinical history: a 38y.o. man with a two years previous diagnosis of primary biliary cirrhosis, presents with mild splenomegaly (13 cm) and mild but persistent decreased platelet number; the other haematological and clinical chemistry tests are all normal; there is,ly a mild increased IgM level. A liver biopsy is performed.
Microscopic description: the liver architecture is preserved; portal spaces and biliary ducts are normal; there is,ly a mild steatosis ( (pict. 1) - (pict. 2)): the primary biliary cirrhosis diagnosis is excluded.
At higher power in the sinusoid there are numerous middle sized, lymphoid cells ( (pict. 3) ), singly or in small aggregates, with irregular and convoluted nuclei. They are strongly positive with the immunocytochemical staining for CD20 ( (pict. 4) - (pict. 5)).
A bone marrow biopsy is then performed; histological sections show a cellular infiltrate similar to that in the liver ( (pict. 6) - (pict. 7) - (pict. 8) - (pict. 9)).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9

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