Composite Lymphoma

Gulati, Rohit; Zhou, Jiehao

doi:10.1007/978-3-030-32189-5_16

Cited by 3 publications

(6 citation statements)

References 63 publications

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“…The most frequent MBCN with more than one clonal population are those where the two populations show CLL immunophenotype (IPT), however, one is K and one is L restricted [2,3,13,14]. Another group would include cases with two morphologically and immunophenotypically distinct MBCN with one of the two has CLL IPT and the other population may have IPT of other MBCN such as hairy cell leukaemia (HCL), mantle cell lymphoma (MCL), or follicular lymphoma or a composite of two distinct MBCN [15][16][17][18]. Normal naïve and reactive mature B-cells are a mixture of kappa or lambda light chain-expressing cells usually in ratio of 1-2:1.…”

Section: Discussionmentioning

confidence: 99%

“…Not to say also the importance of distinguishing biclonal CLL from CLL coexisting with a second lymphoma (composite lymphoma), as different treatment modalities might be needed. Composite lymphoma (CL) implies the coexistence of 2 or more distinct types of lymphoma in a single tissue or organ at presentation [18]. In the MCL/CLL case, the MCL was of the small variant type, and hence, the morphology was suggestive of CLL and the CL was identified exclusively by FCM, which was confirmed by the detection of IGH/CCND1 rearrangement and was reflected by the presence of more than one clone by molecular analysis.…”

Section: Discussionmentioning

confidence: 99%

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Mature B-Cell Neoplasms with Immunophenotypically Distinct Dual B-Cell Clones: A Case Series

2023

Ann Case Report

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mature B-Cell Neoplasms with Immunophenotypically Distinct Dual B-Cell Clones: A Case Series

2023

Ann Case Report

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“…HCL is an uncommon, chronic B-cell leukemia, first reported as a distinct entity in the 1950s [ 1 , 2 ]. HCL accounts for 2% of lymphoid leukemias, with a male predominance and median age at diagnosis of 58 years.…”

Section: Discussionmentioning

confidence: 99%

“…L-NN-MCL tends to present with a lower MIPI/Ki-67 proliferation rate and harbors somatic Ig hypermutation [ 14 ], demonstrating their generally less aggressive features. CD5 negativity is more frequent than in classic MCL [ 1 ]. In addition, recent published data also show decreased SOX11 expression in patients with indolent (smoldering) MCL including L-NN-MCL [ 12 - 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Concurrent Presentation of Hairy Cell Leukemia and Mantle Cell Lymphoma (Leukemic Non-Nodal Variant): An Extremely Rare Composite Lymphoma

Soliman¹,

Ibrahim²,

Fernyhough³

et al. 2022

J Hematol

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Herein, we describe the clinicopathologic and genetic characteristics of the first report of simultaneous bone marrow involvement by classical hairy cell leukemia (HCL) and leukemic non-nodal variant of mantle cell lymphoma (L-NN-MCL) with t(11;14)(q13;q32) with BRAF mutation and deletion of TP53. A 40-year-old asymptomatic man was investigated for incidental neutropenia and thrombocytopenia. Flow cytometry showed two distinct monotypic B-cell populations: one expressed CD19 (bright), CD20 (bright), FMC7, CD103, CD25, CD11c, CD123, and IgD (bright) and showed kappa light chain restriction (bright), consistent with HCL and the other kappa-restricted CD5/CD10-negative B-cell population with distinctive immunophenotypic features. The bone marrow biopsy is infiltrated by an abnormal B-lymphoid infiltrate with different patterns of infiltration in different marrow areas. Fluorescence in situ hybridization (FISH) analysis revealed a CCND1/IGH rearrangement, t(11;14)(q13;q32), and deletion of TP53 . The BRAF V600E missense mutation was detected by quantitative real-time polymerase chain reaction (PCR). The diagnosis of a composite B-cell neoplasm was composed of HCL together with a second CD5/CD10-negative monotypic B-cell population, with CCND1/IGH fusion, favoring the 2016 WHO new category of L-NN-MCL (CD5/SOX11-negative). Treatment with cladribine and rituximab normalized the blood counts within 6 weeks without significant side effects. L-NN-MCL is one of the smoldering MCL subtypes, recently listed in WHO 2016 as a separate variant, with a particular set of unique features and a less aggressive clinical course compared to classical MCL. To date, the clinicopathological features (including the bone marrow findings) of L-NN-MCL have not been sufficiently characterized in the literature. We describe the first report of synchronous presentation of HCL and L-NN-MCL. This case represents a real challenge from the biologic, diagnostic and therapeutic point of views, due to extremely rare combination of two distinct uncommon B-cell neoplasms. The study of composite lymphomas offers the opportunity to evaluate the etiology and the clonal interrelationship involved in the pathogenesis/evolution of lymphomas.

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Deep Visual Proteomics Unveils Precision Medicine Insights in Composite Small Lymphocytic and Classical Hodgkin Lymphoma

Zheng,

Pedersen,

Bzorek

et al. 2024

Preprint

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Coexistence of two cancer types in the same organ presents challenges for clinical decision-making, calling for personalized treatment strategies. Deep Visual Proteomics (DVP) combines AI driven single cell type analysis with laser microdissection and ultrasensitive mass spectrometry. In a composite case of classical Hodgkin lymphoma (cHL) and small lymphocytic lymphoma (SLL) in a single patient, we investigated the potential of DVP to inform precision oncology. We quantified the proteomic landscapes in the cHL and SLL to a depth of thousands of proteins. Our analysis revealed distinct proteome profiles in cHL and SLL populations, highlighting their clonal unrelatedness. Our data suggested standardized chemotherapy and interleukin-4 inhibition as potential strategies to manage chemo-resistance – instead of bone marrow transplantation. DVP highlighted minichromosome maintenance protein and proteasome inhibitors for cHL and H3K27 methylation and receptor tyrosine kinase inhibitors for SLL as subtype-specific treatments. Thus cell-type specific insights of DVP can guide personalized oncological treatments.

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Composite Lymphoma

Cited by 3 publications

References 63 publications

Mature B-Cell Neoplasms with Immunophenotypically Distinct Dual B-Cell Clones: A Case Series

Mature B-Cell Neoplasms with Immunophenotypically Distinct Dual B-Cell Clones: A Case Series

Concurrent Presentation of Hairy Cell Leukemia and Mantle Cell Lymphoma (Leukemic Non-Nodal Variant): An Extremely Rare Composite Lymphoma

Deep Visual Proteomics Unveils Precision Medicine Insights in Composite Small Lymphocytic and Classical Hodgkin Lymphoma

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