Splenic Marginal Zone Lymphoma with Concurrent Myelofibrosis: A Case Report

Myelofibrosis associated with lymphoid neoplasms is a rare occurrence with the exception of hairy cell leukemia. Its incidence in splenic marginal zone lymphoma, as we report in this article, has only been reported once in the past. We report the case of a 62 year old male with splenic marginal zone lymphoma and concurrent myelofibrosis. The diagnosis of splenic marginal zone lymphoma was achieved by a combination of clinical, morphological, and immunohistochemical findings. Increased reticulin staining of the bone marrow, cytopenias and macrocytes on peripheral blood smear supported the diagnosis of myelofibrosis. Features of primary myelofibrosis and other myelodysplastic features including associated genetic mutations were absent. Further investigation of the association between splenic marginal zone lymphoma and concurrent myelofibrosis may assist in future identification of its effect on disease course and overall prognosis, possibly playing a role in risk stratification and personalized therapy. Slonim LB1*, Geller M1, Donovan V1 and Harris J2 1Departments of Pathology, Winthrop-University Hospital, USA 2Departments of Hematotology/Oncology, Winthrop-University Hospital, USA Slonim LB, et al. Clinics in Oncology Lymphoma Remedy Publications LLC., | http://clinicsinoncology.com/ 2016 | Volume 1 | Article 1090 2 hematopoiesis was identified. Reticulin fibrosis was not increased in the spleen. Florescence in-situ hybridization analysis was negative for rearrangements of BCL6 and MALT1 genes. However, three copies of BCL6 gene signals were observed in 82.5% of the cells studied suggesting the presence of trisomy 3 or gain of 3q in the sample. BCRABL1 fusion was negative. Analysis for the JAK2 V617F, JAK2 exon 12 and exon 13, MPL and calreticulin mutations was negative. Serum TGF-beta were not elevated.