Discordant lymphoma consisting of splenic mantle cell lymphoma and marginal zone lymphoma involving the bone marrow and peripheral blood: a case report

Abstract

IntroductionDiscordant lymphomas are rare entities characterized by the simultaneous presence of two distinct types of lymphomas in different anatomic sites. We describe a very rare case of simultaneous occurrence of splenic mantle cell lymphoma and marginal zone lymphoma involving the bone marrow and peripheral blood.Case presentationWe report the case of a 60-year-old asymptomatic Caucasian woman in whom discordant lymphomas were discovered when a slight lymphocytosis and a conspicuous splenomegaly were observed. The different morphological, immunophenotypical and immunohistochemical features found in the different pathologic samples obtained from peripheral blood, bone marrow and spleen sections made it possible to differentiate two types of non-Hodgkin B-cell lymphomas: a mantle cell lymphoma infiltrating the spleen and a marginal zone lymphoma involving both the bone marrow and peripheral blood. Since a similar IgH gene rearrangement was found both in the bone marrow and in the spleen, the hypothesis of a common origin, followed by a different clonal selection of the neoplastic lymphocytes may be taken into consideration.ConclusionOur case emphasizes the usefulness of investigating simultaneous specimens from different anatomic sites from the same patient and the relevant diagnostic role of splenectomy.

Acute Myeloid Leukemia Evolving from JAK 2-Positive Primary Myelofibrosis and Concomitant CD5-Negative Mantle Cell Lymphoma: A Case Report and Review of the Literature

“…While their detailed characterization is still to be completed, data from a small series of 7 cases suggests that these cases have similar clinical features to their CD5-positive counterparts, but may be associated with an unusually long survival, noted in 3 out of 7 cases described [ 21 ]. In two separate case report studies, CD5-negative MCL remarkable for splenic involvement and lacked lymphadenopathy features similar to our case [ 23 , 24 ].…”

“…Of note, this CD5-negative mantle cell lymphoma had a lowproliferation rate and was not associated with lymphadenopathy on repeated imaging studies. While a few prior studies [ 23 , 24 ] suggested that this variant of MCL may have a more indolent behavior, it is not clear if it had or not an impact on the overall progression of the primary myelofibrosis or in the leukemic transformation.…”

Network properties derived from deep sequencing of human B-cell receptor repertoires delineate B-cell populations

“…Both methods utilize PCR and therefore have a risk of systematic over/under-representation of immunoglobulin sequences either through different primer annealing or different amplification efficiencies of the distinct V families (Sandberg et al 2005). Previous studies have qualitatively shown diverse IGH repertoires in healthy patients contrasting with clonal populations in malignancies (Sanchez et al 2003;Campbell et al 2008;Boyd et al 2009;Carulli et al 2011;Logan et al 2011;Maletzki et al 2012) and have also shown that distinct subsets of B-cells within the same individual have distinct repertoires (Wu et al 2010). To date, next-generation sequencing (NGS) of BCRs have primarily focused on classifying the IGHV, D, and J recombination frequencies to understand the diversity of the BCR repertoire (Stewart et al 1997;Sanchez et al 2003;Campbell et al 2008;Boyd et al 2009Boyd et al , 2010Weinstein et al 2009;Wu et al 2010;Jager et al 2012;Lev et al 2012;Maletzki et al 2012).…”