Simultaneous occurrence of peripheral T-cell lymphoma unspecified and B-cell small lymphocytic lymphoma. Report of 2 cases

Campidelli, Cristina; Sabattini, Elena; Piccioli, Milena; Rossi, Mosè; Blasi, D De; Miraglia, Eustachio; Rodríguez-Abreu, Delvys; Franscini, Leda Leoncini; Bertoni, Francesco; Mazzucchelli, Luca; Cavalli, F.; Zucca, Emanuele; Pileri, Stefano

doi:10.1016/j.humpath.2006.10.010

Cited by 31 publications

(36 citation statements)

References 13 publications

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“…The B-cell component is most commonly diffuse large-B-cell lymphoma, followed by hairy cell leukemia, CLL/SLL, splenic marginal zone lymphoma, extranodal marginal zone lymphoma, lymphoplasmacytic lymphoma, and multiple myeloma. 9 On review of the existing literature, we found very rare cases of composite mature T-and small-B-cell lymphocytic lymphoma/CLL (see Table 1). A few of these studies show precedence by the SLL/CLL and make note of the possibility of an atypical evolution of the preexisting low-grade B-cell lymphoma.…”

Section: Discussionmentioning

confidence: 96%

“…2 A review of the published cases shows 13 cases of synchronous or metachronous occurrence of B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) and peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS) in the same biopsy specimen (Table 1). [3][4][5][6][7][8][9] Immune dysregulation as a mechanism underlying the simultaneous occurrence of 2 lymphoid malignancies has been proposed, and the chronic stimulation of T-cells by the neoplastic B-SLL clone is a well-documented phenomenon in the literature. 8 HLH is a syndrome of pathological immune activation characterized by severe inflammation and cytokinemia.…”

Section: Introductionmentioning

confidence: 99%

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Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis

Alomari

Hui

2012

Int J Surg Pathol

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We report a case of a 68-year-old female patient who developed hemophagocytic lymphohistiocytosis (HLH) secondary to peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS) that developed in the setting of treatment-resistant B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL). The patient's B-cell lymphoma had a good initial response to chemotherapy for 4 years, after which it became less responsive and was thought to have undergone transition to a higher-grade lymphoma. Different regimens of chemoradiotherapy were then tried with modest response until the patient presented 3 years later with signs and symptoms of HLH. The patient died 1 month later, and an autopsy was performed. Significant para-aortic lymphadenopathy and splenomegaly were found. Microscopic, immunohistochemical and molecular evaluations confirmed the presence of composite B-cell and T-cell lymphoma in the para-aortic enlarged lymph nodes. Bone marrow examination showed hemophagocytosis, and the liver demonstrated infiltration by activated macrophages with hepatocellular necrosis. This report highlights the importance of searching for a possible underlying T-cell lymphoma in light of HLH. Different theories have been proposed to explain the rare occurrence of concurrent B- and T-cell lymphomas, but the development of HLH in this patient highlights the importance of immune dysregulation as a proposed mechanism to explain some cases of composite lymphomas. A review of the literature and discussion of the relative merits of these hypotheses are presented in the context of this case.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis

Alomari

Hui

2012

Int J Surg Pathol

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“…Several explanations have been proposed for the occurrence of clonally unrelated CLs, [33][34][35] including simple coincidence, genetic predisposition, impaired immune function, and paracrine factors. The temporal sequence of FL and CLL development in case 1 is unknown.…”

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confidence: 99%

Composite Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Follicular Lymphoma Are Biclonal Lymphomas

Boiocchi¹,

Witter

He³

et al. 2012

Am J Clin Pathol

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“…Rare cases of composite lymphoma composed of neoplastic B cell and T cells [1][2][3][4][5][6][7][8] as well as simultaneous or sequential development of B cell and T cell lymphoma in the same patient [9,10] point toward the possibility that rare lymphomas undergo lineage infidelity with resulting clonal development of a T cell lymphoma from a B cell lymphoma and vice versa. A recent large flow cytometry study revealed that lymphomas composed of neoplastic B and T cells constituted mere 0.4 % of all studied lymphomas [7].…”

Section: Introductionmentioning

confidence: 99%

Molecular genetic data favoring a sequential clonal transformation of a large B cell lymphoma into an anaplastic large T cell lymphoma, ALK-negative

et al. 2015

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A large B cell lymphoma with monoclonal rearranged, sequentially identical TRG and near identical IGH genes twice relapsed as an anaplastic large T cell lymphoma, ALK-negative. While these IGH and TRG rearrangements were also detected in both relapsed lymphomas, near identical IGK rearrangement was present in the primary and the first relapse, though not in the second relapse, and identical TRB rearrangement was detected only in both relapses, not in the primary. Normal T lymphocytes were the only T cell component found in the primary lymphoma, thus excluding a possibility that the primary lymphoma was a classic composite B and T cell lymphoma. Our data, particularly, the presence of sequentially identical monoclonal TRG and near identical IGH rearrangement in the primary and both relapsed lymphomas, favor a gradual transformation of a B cell lymphoma into a T cell lymphoma. In our opinion, this previously not described phenomenon likely represents a composite lymphoma in statu nascendi.

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Simultaneous occurrence of peripheral T-cell lymphoma unspecified and B-cell small lymphocytic lymphoma. Report of 2 cases

Cited by 31 publications

References 13 publications

Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis

Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis

Composite Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Follicular Lymphoma Are Biclonal Lymphomas

Molecular genetic data favoring a sequential clonal transformation of a large B cell lymphoma into an anaplastic large T cell lymphoma, ALK-negative

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