Splenic lymphoma with villous lymphocytes presenting as leucocytoclastic vasculitis

We describe a 69-year-old woman who presented with purpura on the legs. Exa mination of a blood film revealed a homogenous population of abnormal lymph oid cells with villous projections. The immunophenotype was consistent with a diagnosis of splenic lymphoma with villous lymphocytes (SLVL). A type II (IgM-IgG) cryoglobuIin was detected in the serum. Renal biopsy demonstrate d a membranoproliferative type I glomerulonephritis with intraluminal IgG a nd IgM deposits, and a skin biopsy showed a leucocytoclastic vasculitis wit h outlining of the vessels by IgG and IgM. Vasculitis has been reported in association with a number of haematological malignancies, most frequently w ith hairy cell leukaemia. To our knowledge this is the first report of SLVL presenting with cryoglobulinaemic vasculitis.