Splenic lymphoma with villous lymphocytes: case report

We present the case of malignant Non-Hodgkin splenic lymphoma with villous lymphocytes regarded as atypical chronic lymphoid leukemia. This was a 62 years old male patient admitted in the Haematologic Department of Brazzaville Teaching Hospital for an enlarged spleen, anaemia and lymphocytosis. The initial abdominal CT noticed a homogenous splenomegaly and a large retroperitoneal tumour mass measuring 148 X 101mm. The initial count blood cell revealed a lymphocytosis with a lymphocyte count at 82 Giga/l, severe anaemia with a haemoglobin rate at 4.2g/dl, platelet count at 68 Giga/l. Peripheral smear examination showed irregular lymphoid cells with a homogenous distribution, condensed chromatin corresponding to villous lymphocytes. Immunophenotyping showed B lymphoid monotypic population cells positive for CD19, CD 20, and FMC7, moderately positive for CD23 and negative for CD5, CD43 and CD 79b. Therapeutically, combination chemotherapy RCVAD (Rituximab, Vincristin, Daunorubicin, Dexamethasone) give good clinical and haematological response. This report illustrates the need for excellent interdisciplinary collaboration and the interest of the cytology and immunophenotyping in the lymphoid proliferation management

Multifocal tuberculous osteomyelitis/osteochondritis of ribs in patient with sickle cell disease

Tuberculosis rib osteomyelitis is a rare clinical entity that is more prevalent in developing countries. We report the case of multifocal tuberculous osteomyelitis/osteochondritis of ribs on a 23 years old sickle cell female patient. This observation aims to raise the awareness of rib osteomyelitis for which mycobacterium tuberculosis is the first pathogen involved in the process in developing countries

Imatinib mesylate in chronic myelogenous leukemia: a Congolese experience

Background: Chronic myeloid leukemia is a clonal myeloproliferative disorder caused by reciprocal translocation t(9;22) that induces tyrosin kinase protein. Imatinib is a selective inhibitor of this protein.Objectives: To assess responses to imatinib and outcome of Congolese patients with chronic phase chronic myeloid leukemia.Design: retrospective study.Settings: Clinical Haematology unit of Teaching Hospital in Brazzaville, CongoSubjects: Newly diagnosed patients with chronic phase chronic myeloid leukemia treated with imatinib.Results: A total of 25 males and 14 females with a mean age of 36 years at time of the diagnosis were enrolled in the study. The mean duration of the illness was 11.4 months. Imatinib induced complete hematologic response at 3 months in 100%. Major cytogenetic response was noticed in 87.18%. After a median follow up of 12 months, chronic myeloid leukemia had not progressed to the accelerated or blastic phase in an estimated 91.8% of patients and 86.6% were alive.Conclusion: Imatinib is effective in newly chronic phase chronic myeloid leukemia patient even though cytogenetic response rate are lower in Africa than western countries population