Teaching Cases from the Royal Marsden Hospital Case 3: a lymphoproliferative disorder of 17 years duration

Abstract

CASE A 62 year old female presented in July 1973 with generalized lymphadenopathy. The WBC was 9.3 × 109⁹/1 with a lymphocyte count of 3.5 × 10⁹/1 and some “atypical” lymphocytes. There was also eosinophilia. Two lymph node biopsies performed in the next few weeks and reviewed by two senior histopathologists were interpreted as showing reactive lymphadenitis. The patient subsequently developed hepatomegaly and splenomegaly and despite the initial histological diagnosis was treated with six courses of combination chemotherapy (MVPP regimen). She remained well and under medical supervision for the next six years but was then lost to follow-up for the subsequent seven years.

Key Words:

• Chronic lymphocytic leukaemia
• lymphoplasmacytic lymphoma