International Journal of Hematology

, Volume 90, Issue 5, pp 601–604 | Cite as

Complete remission of splenic marginal zone lymphoma after an acute flare-up of hepatitis B in a hepatitis B virus carrier

  • Katsuya Fujimoto
  • Tomoyuki Endo
  • Mitsufumi Nishio
  • Masato Obara
  • Keisuke Yamaguchi
  • Yukari Takeda
  • Hideki Goto
  • Ikumi Kasahara
  • Norihiro Sato
  • Takao Koike
Case Report

Abstract

A 44-year-old female presented with asymptomatic leukocytosis and moderate splenomegaly. The diagnosis of splenic marginal zone lymphoma (SMZL) was made by a splenectomy. A virological examination revealed the patient to be a hepatitis B virus (HBV) carrier. The lymphocyte count in her peripheral blood decreased after splenectomy, but remained high for 2 years and bone marrow infiltration was obvious. Two years after the splenectomy, she was admitted for an acute flare-up of hepatitis B. The liver dysfunction improved without any medication and thereafter returned to the normal range within a few weeks. At the same time, the lymphocyte count in her peripheral blood rapidly decreased to normal levels. Atypical lymphocytes disappeared from the peripheral blood and bone marrow aspirates and biopsy specimen revealed complete remission of SMZL, including the disappearance of the clonal rearrangement of IgH-JH. There has been no recurrence of acute hepatitis and she has been in complete remission for SMZL for more than 6 years. The clinical course of this patient suggests that an immune response against HBV also affects the clearance of lymphoma cells. This is the first report that a complete remission was achieved in a patient with SMZL after a hepatitis B flare-up.

Keywords

Malignant lymphoma Splenic marginal zone lymphoma Hepatitis B virus Acute hepatitis 

Notes

Acknowledgments

The authors are grateful to I. Sato for technical assistance and Brian Quinn for language assistance.

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Copyright information

© The Japanese Society of Hematology 2009

Authors and Affiliations

  • Katsuya Fujimoto
    • 1
  • Tomoyuki Endo
    • 1
  • Mitsufumi Nishio
    • 1
  • Masato Obara
    • 1
  • Keisuke Yamaguchi
    • 1
  • Yukari Takeda
    • 1
  • Hideki Goto
    • 1
  • Ikumi Kasahara
    • 1
  • Norihiro Sato
    • 2
  • Takao Koike
    • 1
  1. 1.Department of Internal Medicine IIHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Translational Research and Clinical Trial CenterHokkaido University HospitalSapporoJapan

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