A Rare Case of Concomitant Small Lymphocytic Lymphoma and Kaposi's Sarcoma in the Same Lymph Node Biopsy

Case Report

Ann Hematol Oncol. 2014;1(3): 1013.

A Rare Case of Concomitant Small Lymphocytic Lymphoma and Kaposi's Sarcoma in the Same Lymph Node Biopsy

Madonna E1*, Avilia S1, Catalano L1, De Rosa G1 and Pane F1

1Department of Clinical Medicine, Federico II University, Italy

*Corresponding author: Madonna E, Division of Hematology, Department of Clinical Medicine, Federico II University, Naples, Italy

Received: October 26, 2014; Accepted: November 28, 2014; Published: December 02, 2014


Small Lymphocytic Lymphoma (SLL) and its leukemic variant, Chronic Lymphocytic Leukemia (CLL), are the most common B-cell lymphomas in western countries.

In CLL/SLL, cutaneous or mucous membranes lesions occur in up to 25% of patients: infection or hemorrhage are the most common aetiologies, but they can also be an early manifestation of skin malignancy, as, when compared with normal population, in CLL/SLL skin cancer risk is increased eightfold.

Herein, we describe a case in which Kaposi Sarcoma (KS) and SLL were contemporary diagnosed in the same lymph node biopsy: concomitant diagnosis of KS and CLL/SLL is rare, and even rarer is the observation of the coexistence of both diseases in the same biopsy.

Keywords: Small Lymphocytic Lymphoma; Chronic Lymphocytic Leukemia; Kaposi Sarcoma

Case Presentation

A 61 years-old male was referred to our Haematology Division in May 2012, for diffuse asymptomatic lymphoadenopathy, appeared about one month earlier. He had not been exposed to immunosuppressive therapy nor had congenital or acquired immunodeficiency. Peripheral blood counts were: Hb 14.8 g/dL, WBC 6.250/μL, ANC 2.625/ μL, Platelets 163.000/ μL, Lymphocytes 3000/ μL.

CT scan showed multiple enlarged nodules on both sides of diaphragm, mainly in abdomen (para-aortic, maximum size: 28 mm).

After one week, the patient also showed small purple-blue cutaneous lesions on the left leg, associated with venous stasis, lymphedema, and hyperkeratosis. Color Doppler ultrasonography excluded vascular abnormalities.

Cervical lymph node biopsy showed diffuse architectural effacement due to infiltration of small monomorphous lymphocytes, with round nuclear contours and scant cytoplasm, without significant mitotic activity. Surface Immunophenotyping profile was: CD19+, CD5+/-, CD23+, CD20+/-, CD22+, lambda+. A small area with a multicentric proliferation of spindle-shaped, Human-herpesvirus positive (HHV8+) cells, with erythrocyte extravasations, was also evident in the sub capsular zone. Histological diagnosis was Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL) associated with Kaposi Sarcoma (KS) (Figure 1). Histhology of skin nodules was not performed. Bone marrow aspiration and biopsy revealed marked hypercellularity with nodular infiltration by small CD20+ and faintly CD5+ lymphocytes, supporting the diagnosis of SLL.