비장변연부 B세로 림프종 1예
A Case of Splenic Marginal Zone Lymphoma
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비장변연부 림프종은 비장종대, 림프구 증가 소견, 골수내 전이시 동모양구조내로의 침윤 등을 특징으로 하는 저등급의 B 세포 림프종의 일종으로 그 빈도는 비호지킨 B 세포 림프종의 1%미만을 차지하는 매우 드문 질환이나 비교적 양호한 경과를 보이는 림프종이다. 저자들은 뚜렷한 이유 없이 심한 비장종대를 동반하면서 말초혈액에서 B 림프구 증가를 보이는 61세 남자 환자에서 환자의 골수검사와 함께 시행한 비장 조직의 면역조직화학염색과 유세포분석검사를 통하여 비장변연부 림프종이라 확진한 1예를 경험하였기에 보고하는 바이다. 환자는 현재 비장적출 후 만성폐쇄성 폐질환에 대한 치료중이며 향후 화학요법 치료예정이다.
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare B-cell neoplasm characterized by massive splenomegaly, moderate lymphocytosis, bone marrow intrasinusoidal involvement of lymphocytes and a relatively indolent course. We report a case of SMZL diagnosed by bone marrow studies using immunophenotyping and immunohistochemical stain, and confirmed by splenectomy. The patient was a 61-year old male, who showed mild lymphocytosis in peripheral blood and bone marrow aspirates. Immunophenotyping of bone marrow aspirates showed lymphocytes positive for CD19, CD20, CD22 (dim), CD23 (dim) and negativie for CD5 and CD10. The immunohistochemistry of bone marrow and spleen also showed lymphocytes positive for CD20 and negative at for cyclin D1. Now he is being treated for chronic obstructive pulmonary disease and will receive chemotherapy. (Korean J Lab Med 2004; 24: 11-4)
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