DUAL REARRANGEMENT OF IMMUNOGLOBULIN AND T-CELL RECEPTOR GENES IN A CASE OF SPLENIC LYMPHOMA WITH VILLOUS LYMPHOCYTES

We report here a case of ''splenic lymphoma with villous lymphocytes'' (SLVL) which exhibited both B- and T-cell phenotypes and genotypes, T he patient was a 73-year-old man. Physical examination revealed spleno megaly and lymphadenopathy. The white blood cell count was 55.2 x 10(9 )/L with 70.5% atypical lymphocytes, having cytoptasmic villi, charact eristic of SLVL. The atypical cells infiltrated both the red and white pulps. Immunological analysis of the peripheral leukocytes showed bot h B- and T-cell phenotypes (CD5, CD11c, CD19, CD20, HLA-DR, SmlgM and lambda positive). DNA analysis revealed a dual rearrangement of the im munoglobulin heavy chain gene and T-cell receptor beta gene. SLVL has been identified as a B-cell leukemia with a relatively benign clinical course. This case had both B- and T-cell pheno- and genotypes with a progressive course. To the best of our knowledge, no case of SLVL with dual genotypes has ever been reported.