A 60-year-old man presented with hemolytic anemia and thrombocytopenia. The direct Coombs test was positive, and IgG antibody was identified. Physical examination showed splenomegaly, but no peripheral lymphadenopathy was detected. Flow cytometric analysis of the peripheral blood revealed a monoclonal population. A bone marrow biopsy showed intrasinusoidal B-cell infiltration (Fig. 33.1). His anemia and thrombocytopenia were progressive even with multiple blood transfusions. A splenectomy was finally performed. The histiology of the splenectomy specimen is illustrated in Figs. 33.2 and 33.3. One week after splenectomy, his hemoglobin, hematocrit, and platelet count returned to normal levels, and no transfusion was required.


Mantle Cell Lymphoma Hairy Cell Leukemia White Pulp Hematologic Neoplasm Splenic Marginal Zone Lymphoma 
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