Hepato-splenic Gamma Delta T-cell Lymphoma in Bangladesh: Case Report on a Challenging Entity

Abstract

With a unique development pattern and clinical context, Hepato-splenic Gamma Delta Lymphoma is an unusual but distinct T-cell lymphoma. Hepatosplenomegaly, anemia, thrombocytopenia, no swelling of superficial lymph nodes, and an aggressive clinical course are its defining features, which manifest at a young age. In this case report, a 48 years old male Hb-E trait patient with a history of splenectomy attended the Department of Hematology of Rajshahi Medical College and Hospital with hepatomegaly, weakness, anorexia and feverish feeling. The hematological report revealed anemia whereas total WBC and platelet count were within normal range. Bone marrow aspiration showed hypercellularity with all precursors. Bone marrow biopsy showed hyperplastic marrow with focal abnormal infiltration of medium-sized lymphoid cells. The diagnosis was confirmed by flow cytometry correlating clinical and other investigation findings. This lymphoma is difficult to diagnose due to its rarity, absence of nodal involvement, and symptoms that mirror other entities, particularly infectious etiologies. In such circumstances, whereas bone marrow is the primary diagnostic modality, the pattern of involvement can be modest. As a result, understanding the pattern of involvement and supporting research would aid in precise diagnosis, early treatment, and increased survival rates.