A Case of Bone Marrow Lymphoma with Pancytopenia

Abstract

Bone marrow lymphoma is a rare disease. Herein, we report a case of a 77-year old woman who was diagnosed with primary bone marrow lymphoma. She presented with fatigue and dyspnea 1 month before hospitalization. Two weeks before hospitalization, she underwent blood tests, and her complete blood count revealed pancytopenia. A bone marrow biopsy was performed and showed abnormal and diffuse lymphoid cells. On immunohistochemistry, these cells were positive for leukocyto common antigen (LCA), CD20, and Bcl-2. Upon further examination, there was no palpable lymphadenopathy. A positron emission/computed tomography (PET/CT) scan revealed fluorodeoxyglucose (FDG) uptake only by the vertebra and pelvic bone. The patient received R-T-COP chemotherapy (rituximab, cyclophosphamide, pirarubicin, vincristine, and prednisolone). Despite chemotherapy, the disease became refractory, and the patient died 3 months after chemotherapy. Based on this case, we recommend for pancytopenia to be considered a symptom of bone marrow lymphoma.