Visceral leishmaniasis concurrent with splenic marginal zone B-cell lymphoma

Abstract

Splenic marginal zone B-cell lymphoma (SMZBCL) is a rare non-Hodgkin B-cell lymphoma that presents with morphologically mature lymphoid cells corresponding in their immunological characteristics to secondary follicular marginal zone lymphocytes. It is clinically characterized by splenomegaly, moderate lymphocytosis, usually focal bone marrow lesion, sometimes moderate of monoclonal immunoglobulin in the serum (generally IgM or IgG) and/or urea, and a relatively benign course. Leishmaniasis is a transmissible natural focal infectious endemic disease that has a great diversity of clinical manifestations. The authors describe Russia's first case of SMZBCL concurrent with visceral leishmaniasis in a 52-year-old female patient admitted to a hematology hospital with weakness, splenomegaly, and lymphadenopathy. The simultaneous detection of lymphoma and leishmaniasis in the same biopsy specimen is extremely rare. Visceral leishmaniasis should be borne in mind as an opportunistic infection in patients with malignancies, particularly in immunocompromised persons who live or have stayed in the endemic areas.

Chronic amastigote‐negative cutaneous leishmaniasis: A clinical, histopathologic and molecular study of 27 cases with emphasis on atypical and pseudolymphomatous presentations

“…Clonal pseudolymphomatous CL and MZL harboring Leishmania DNA might well represent different steps of clonal selection in the context of a chronic lymphoproliferative process, in keeping with the theory of the oncogenic role of microbiologic agents with important clinical, molecular, biological and therapeutic implications. Development of splenic MZL concurrent, or following visceral Leishmania infection, have been occasionally reported in the literature …”

Rapid Clinical Management of Leishmaniasis in Emergency Department: A Case Report with Clinical Review of Recent Literature

“…Early symptoms and signs of leishmaniasis include fever, hepatomegaly, splenomegaly, pancytopenia, progressive anemia, and weight loss. Such a clinical presentation can easily be misleading, and the physician is usually oriented toward a diagnosis of a hematologic disease [ 52 ].…”