Mantle cell lymphoma with EBV‐positive Hodgkin and Reed–Sternberg‐like cells in a patient after autologous PBSCT: Phenotypically distinct but genetically related tumors

The co-occurrence of several lymphomas in a patient defines composite/synchronous lymphoma. A common cellular origin has been reported for both contingents of such entities. In the present review, we aimed to gather the available data on composite lymphomas associating a classical Hodgkin lymphoma (cHL) with another lymphoma, to better understand the plasticity of mature B and T-cells. This review highlights that >70% of patients with a composite lymphoma are ≥55 years old, with a male predominance. The most reported associations are cHL with follicular lymphoma or diffuse large B-cell lymphoma, with over 130 cases reported. The cHL contingent is often of mixed cellularity type, with a more frequent focal/weak CD20 expression (30% to 55.6%) compared to de novo cHL, suggesting a particular pathophysiology. Moreover, Hodgkin cells may express specific markers of the associated lymphoma (e.g., BCL2/BCL6 for follicular lymphoma and Cyclin D1 for mantle cell lymphoma), sometimes combined with common BCL2/BCL6 or CCND1 rearrangements, respectively. In addition, both contingents may share similar IgH/IgK rearrangements and identical pathogenic variants, reinforcing the hypothesis of a common clonal origin. Finally, cHL appears to be endowed with a greater plasticity than previously thought, supporting a common clonal origin and a transdifferentiation process during lymphomagenesis of composite lymphomas.

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“…A total of 11 cHL/mantle cell composite lymphomas from 10 articles were analyzed [ 6 , 8 , 9 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ].…”

Section: Resultsmentioning

confidence: 99%

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

Trécourt

Donzel

Fontaine

et al. 2022

Cancers

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“…Though MDM2 expression is associated with poor prognosis in MCL, our study shows that all cases of MCL were immunonegative for MDM2 [ 25 ]. Similarly, very few reports showed immunopositivity for EBV-LMP1 [ 26 ].…”

Section: Discussionmentioning

confidence: 98%

Clinicopathological and Immunohistochemical Profile of Mantle Cell Lymphoma: An Institutional Experience

Mishra¹,

Padhi²,

Ayyanar³

et al. 2021

Cureus

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IntroductionMantle cell lymphoma (MCL) is a biologically aggressive B-cell non-Hodgkin lymphoma (NHL) with distinctive morphologic, immunophenotypic, and molecular characteristics. Differentiation from other chronic lymphoproliferative disorders is essential for prognostication. AimThis paper aims to study the clinicopathological features of MCL with emphasis on immunohistochemical features and disease correlation. MethodTo do so, clinicopathological characteristics from 21 cases of MCL (14 males, seven females, M:F=2:1) diagnosed in the last five years i.e. 2015 to 2020, were retrospectively reviewed and correlated with immunohistochemistry (IHC) data. Particularly those pertaining to cyclin D1, SRY-box transcription factor 11 (SOX11), cluster of differentiation (CD) 5, CD23, MIB E3 ubiquitin protein ligase 1 (MIB1), tumor protein 53 (TP53), c-myelocytomatosis oncogene product (c-MYC), multiple myeloma oncogene 1 (MUM1), mouse double minute 2 homolog (MDM2), and Epstein-Barr virus latent membrane protein 1 (EBV-LMP1) expression with its aberrations. ObservationsThis study shows that MCL constituted 4.2% (21/500) of all NHLs with a mean age of 57.5 years (median 60 years, range 30 to 80 years). The disease was nodal in 19, and extranodal in the remaining two cases. 14 of 21 (67%) had generalized lymphadenopathy and 71% had bone marrow (BM) involvement. The nodal involvement was diffuse in 9/17 (53%), 8/21 (38%) had a blastoid morphology, and an in-situ MCL pattern was not seen in any of the cases selected for the study. Cyclin D1 immunoexpression correlated well with SOX11; CD5-negative in five cases; and CD23-positive in three cases. TP53 and c-MYC expression were noted in 17/19 (89.4%) and 8/17 (47%), respectively. MUM1 registered positive in six cases. None of the cases showed immunopositivity for MDM2 and EBV-LMP1. ConclusionIn essence, this study indicates that morphological and immunophenotypic subclassification of mantle cell lymphoma with a wider panel of IHC markers is essential for understanding disease biology and better prognostication.

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“…In 2021, Kanai et al. ( 16 ) reported a patient with MCL who relapsed into nodular lymphoma with MCL and classical HL 9 years after undergoing autologous peripheral blood stem cell transplantation. EBV was detected in HRS-like cells in the MCL background, while CCND1 and SOX11 expression was attenuated or absent.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to the complex life cycle and biological behavior of EBV, its role in MCL remains unknown. According to the currently available research studies, it is hypothesized that EBV may be associated with the transformation of MCL to Hodgkin’s lymphoma (HL) or more aggressive lymphoma ( 16 ). Therefore, it is necessary to correctly recognize and diagnose MCL with EBV infection.…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic study of mantle cell lymphoma with epstein-barr virus infection: A case series and literature review

Zhou

et al. 2022

Front. Oncol.

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BackgroundMantle cell lymphoma (MCL) with Epstein–Barr virus (EBV) infection is rarely reported. The objective of this study was to analyze the prevalence and clinicopathological features of MCL with EBV infection in the largest series thus far.MethodsAfter screening 138 cases of MCL, we identified eight cases of MCL with EBV infection.ResultsMost of them (7/8) had non-neoplastic bystander cells with positivity for EBV and no expression of latent membrane protein 1 (LMP1) and EBV nuclear antigen 2 (EBNA2). The cases of MCL with EBER positivity did not have abnormal immune function or other lymphomas. Moreover, their histopathological morphology was indicative of classical MCL. Cases of MCL with EBER positivity exhibited statistically significant differences in lactate dehydrogenase, anemia status, and MCL international prognostic index grouping (P=0.008, P=0.02, P=0.001, and P=0.011, respectively). The differences between the two groups in age, sex ratio, clinical manifestations, and immunohistochemical phenotypes were not statistically significant.ConclusionsThe incidence of MCL with EBV infection was low (5.8%). Clinicopathologically, cases of MCL with EBER positivity were similar to their EBV-negative counterparts. Our findings revealed that most cells infected by EBV in MCL are background cells rather than tumor cells. This is inconsistent with data from previous studies, indicating that tumor cells in MCL may not be prone to EBV infection.

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Mantle cell lymphoma with EBV‐positive Hodgkin and Reed–Sternberg‐like cells in a patient after autologous PBSCT: Phenotypically distinct but genetically related tumors

Cited by 5 publications

References 14 publications

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

Clinicopathological and Immunohistochemical Profile of Mantle Cell Lymphoma: An Institutional Experience

Clinicopathologic study of mantle cell lymphoma with epstein-barr virus infection: A case series and literature review

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