Large-cell transformation of a composite lymphoma

diSibio, Guy; Gabor, E. Peter; Lopategui, Jean; Sabath, Daniel E.; Alsabeh, Randa; Cole, Justin M.

doi:10.1016/j.yexmp.2010.07.001

Cited by 3 publications

(7 citation statements)

References 16 publications

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“…Among the three reported cases (including ours) of composite lymphoma with FL, SLL and DLBCL elements, ours is the only one in which an IGH-BCL2 fusion demonstrable by FISH was available to support the inference that the DLBCL component evolved directly from FL. This finding agrees with those of diSibio and colleagues who demonstrated the presence of an IGH-BCL2 fusion in both the FL component of a composite lymphoma and a DLBCL that arose 15 years later [ 4 ]. Our case is also the first in which FISH demonstrated the presence of a MYC rearrangement in the DLBCL, but not the FL, component.…”

Section: Discussionsupporting

confidence: 92%

“…Use of the polymerase chain reaction (PCR) with primers for the IGH locus has demonstrated that the FL and CLL/SLL components contained different clonal rearrangements in 3 composite lymphomas, suggesting that these two components either arose from different clones ab initio or diverged prior to IGH gene rearrangement [ 2 , 3 ]. Also in support of a separate clonal origin, FISH was used to demonstrate IGH-BCL2 fusion in the FL, but not the SLL/CLL, component in an additional 2 cases (including ours) [ 4 ]. In contrast, Zhang and colleagues reported results from IGH PCR that suggested clonal identity between the FL and SLL components in 3 cases of composite lymphomas [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

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High-grade B-cell lymphoma with MYC and BCL2 rearrangements arising in a composite lymphoma

Moore

Moshkin²,

Swain³

et al. 2018

Diagn Pathol

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BackgroundWe report the first case of composite lymphoma consisting of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), follicular lymphoma (FL) and high-grade B-cell lymphoma with MYC and BCL2 rearrangements within the same needle biopsy in which a clonal relationship between the FL and high-grade B-cell lymphoma components was demonstrated by molecular cytogenetics.Case presentationAn 85-year-old man presented with masses in his neck and right groin. Cutting needle biopsy of the inguinal mass revealed the three lymphoma types which were morphologically, immunophenotypically and topographically distinct. Fluorescence in situ hybridization (FISH) identified an IGH-BCL2 rearrangement in both the FL and high-grade B-cell components while a MYC rearrangement was detected in the high-grade B-cell component alone.ConclusionsOur findings suggest that the high-grade lymphoma with MYC and BCL2 translocations evolved through transformation of the FL by a process that entailed acquisition of the MYC translocation. No clonal relationship between the FL and CLL/SLL components was evident since the IGH-BCL2 rearrangement was present in in the former but not the latter. This unique case of co-localized FL, CLL/SLL, and high-grade B-cell lymphoma contributes to our understanding of the clonal relationships that may exist between the components of composite lymphomas.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

High-grade B-cell lymphoma with MYC and BCL2 rearrangements arising in a composite lymphoma

Moore

Moshkin²,

Swain³

et al. 2018

Diagn Pathol

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“…Their clinical course and pathogenesis remain relatively unknown due to a low incidence. [7][8][9][10][11][12][13][14][15][16] In this article, we report 6 composite SLL/CLL and FL cases and studied their clinical, histologic, immunophenotypic, and cytogenetic features. A literature review of the existing cases was also conducted.…”

Section: Introductionmentioning

confidence: 99%

Composite Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia and Follicular Lymphoma: A Clinicopathological Study of Six Cases

et al. 2017

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“…A report of T lymphoblastic leukemia/lymphoma and diffuse large B cell lymphoma was recently published. Some of these have been reported to be monoclonal [1,6,[19][20][21], while others appear to be biclonal [10][11][12][13][14][15][16][17][18]. Analysis of clonality is important for the understanding of the origins of composite lymphomas.…”

Section: Discussionmentioning

confidence: 99%

“…Composite lymphomas with cytogenetic or molecular evidence of biclonality have also been reported, especially composite B and T-cell lymphomas [10][11][12][13][14][15][16][17][18]. Recently, several morphologically and immunophenotypically different lymphomas have been shown to be clonally related [1,[6][7][8][19][20][21]. For this investigation, we identified five archived cases of composite lymphoma based on morphologic and immunophenotypic criteria and applied molecular techniques to assess their clonality.…”

Section: Introductionmentioning

confidence: 99%

Two morphologically and immunophenotypically distinct cell populations within a composite lymphoma arise from a common precursor

et al. 2011

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The term composite lymphoma defines a lymphoma consisting of two or more morphologically and immunophenotypically distinct lymphomas within the same lymph node or other organ. Recently, several molecular studies have shown that different components within a composite lymphoma may arise from a common clone. In contrast, there are also reports of biclonal cases of composite lymphoma. For this study, we identified five cases of composite lymphoma and analyzed them by various techniques to determine the clonality of the components. In four cases (1-4), a laser capture microdissection technique was used to collect separately each of the component lymphoma types. These were analyzed by polymerase chain reaction (PCR) to assess the rearrangement of the J segment of the immunoglobulin heavy chain gene (JH). In all cases, gel electrophoresis demonstrated that the JH amplicons from each component were identical in size. DNA sequencing of the amplified JH region was successful in three of these four cases (1, 3, and 4), and the sequences of the JH regions of both components of each composite lymphoma were identical. Three of the composite lymphomas (2, 4, and 5) were also tested by a related approach: PCR of the variable region of the immunoglobulin heavy chain gene using primers that bind to framework regions 1, 2, and 3, followed by capillary electrophoresis. The PCR amplicons from tissue containing a mixture of both components of the composite lymphomas gave one major peak in each of the three electropherograms for each lymphoma, indicating that only one clone of rearranged immunoglobulin was present despite the two distinct cellular morphologies. Additionally, fluorescence in situ hybridization in case one showed identical results in the two different cell types. Our results suggest that the two different components within each composite lymphoma represent a morphologically and immunophenotypically divergent differentiation of a common clone.

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Large-cell transformation of a composite lymphoma

Cited by 3 publications

References 16 publications

High-grade B-cell lymphoma with MYC and BCL2 rearrangements arising in a composite lymphoma

High-grade B-cell lymphoma with MYC and BCL2 rearrangements arising in a composite lymphoma

Composite Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia and Follicular Lymphoma: A Clinicopathological Study of Six Cases

Two morphologically and immunophenotypically distinct cell populations within a composite lymphoma arise from a common precursor

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