A 63-year old man presented with massive splenomegaly, lymphadenopathy and a total leucocyte count of 17000 per mm3. The flow cytometery showed CD 19 +, CD5 +, CD23 -, monoclonal B-cells with bright kappa positively comprising 80% of the peripheral blood lymphoid cells. Which of the following is the most likely diagnosis?
Patient in the question is showing features of mantle cell lymphoma. Mantle cell lymphoma is a subtype of non Hodgkins lymphoma. Patients often presents with lymphadenopathy at several sites along with fever, night sweats or weight loss. On examination hepatomegaly and spleenomegaly is evident. Investigations: Translocation of chromosome t(11:14) result in over expression of cyclin D1. Biopsy of lymph node mostly shows a diffuse enlargement of lymph node, rarely a mantle zone pattern. The flow cytometery shows CD 19 +, CD5 +, CD23 -ve monoclonal B-cells with bright kappa positivity. Ref: Williams Hematology, 8th Edition, Chapter 95, Pages 101 - 2
Mantle cell lymphoma
Follicular lymphoma
Hairy cell leukemia
Splenic lymphoma with villous lymphocytes