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Biclonal lymphoma

Sam Vander Meeren, Bert Heyrman, Wim Renmans, Marleen Bakkus, Brigitte Maes, Hendrik De Raeve, Rik Schots, Kristin Jochmans
High-count monoclonal B cell lymphocytosis (MBL) with a chronic lymphocytic leukemia (CLL) phenotype is a well-known entity, featuring 1-4% annual risk of progression towards CLL requiring treatment. Lymphoma-like MBL (L-MBL), on the other hand, remains poorly defined and data regarding outcome are lacking. We retrospectively evaluated 33 L-MBL cases within our hospital population and compared them to 95 subjects with CLL-like MBL (C-MBL). Diagnoses of L-MBL were based on asymptomatic B cell clones with Matutes score < 3, B cells < 5...
February 28, 2018: Annals of Hematology
John Tanaka, Pu Su, Catherine Luedke, Rachel Jug, Lian-He Yang, Kristen Deak, Sarah Horn, Yang Zhang, Marc Delos Angeles, Yi Xie, Endi Wang
Composite lymphoma (CL) of T-/B-cell type is rare, and follicular lymphoma composite with peripheral T-cell lymphoma (PTCL) has not previously been reported. We report such a case with both neoplastic components displaying a unique zone of distribution. A 75-year-old male patient presented with generalized lymphadenopathy. Sections of axillary lymph node demonstrated potentially two clonal processes, PTCL with aberrant CD20 expression and follicular lymphoma. Interestingly, the two neoplastic components were confined to their respective classic distribution zones, with PTCL occupying the interfollicular areas and follicular lymphoma residing in follicles...
December 4, 2017: Human Pathology
Ling Guo, Zhen Wang, Courtney M Anderson, Emerald Doolittle, Siobhan Kernag, Claudiu V Cotta, Sarah L Ondrejka, Xiao-Jun Ma, James R Cook
The assessment of B-cell clonality is a critical component of the evaluation of suspected lymphoproliferative disorders, but analysis from formalin-fixed, paraffin-embedded tissues can be challenging if fresh tissue is not available for flow cytometry. Immunohistochemical and conventional bright field in situ hybridization stains for kappa and lambda are effective for evaluation of plasma cells but are often insufficiently sensitive to detect the much lower abundance of light chains present in B-cells. We describe an ultrasensitive RNA in situ hybridization assay that has been adapted for use on an automated immunohistochemistry platform and compare results with flow cytometry in 203 consecutive tissues and 104 consecutive bone marrows...
March 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Ahmad T Mansour, Alaleh Esmaeili Shandiz, Michelle K Zimmerman, Trenton D Roth, Jiehao Zhou
BACKGROUND: Lymphoplasmacytic lymphoma and plasma cell myeloma are two B cell lymphoproliferative neoplasms derived from mature B-lymphocytes in different differentiation stages. The coexistence of these two tumors in the same patient is exceedingly rare and can be difficult to diagnose. CASE PRESENTATION: A 76-year-old male presented with a pathologic fracture after a fall. Radiography showed a lytic lesion in the pelvis. Serum immunofixation showed distinct IgM kappa and IgA kappa monoclonal protein bands...
2017: American Journal of Blood Research
Siddhesh Arun Kalantri, Uttam Kumar Nath, Debasis Banerjee, Maitreyee Bhattacharyya
Plasmablastic lymphoma, a rare highly aggressive non-Hodgkin's lymphoma subtype, often associated with HIV infection, is a close differential diagnosis of plasmablastic myeloma. The 2 conditions may be morphologically and immunophenotypically identical. However, differentiating between the 2 conditions is critical for adequate patient management. Herein, we describe an unusual case of plasmablastic myeloma with biclonal gammopathy which was initially diagnosed as plasmablastic lymphoma based on lymph node biopsy and immunohistochemistry (IHC) results...
March 20, 2017: BMJ Case Reports
Bin Wu, Kimberly Ingersoll, Catherine Rehder, Endi Wang
Chronic lymphocytic leukemia (CLL) is an indolent mature B-cell neoplasm. During a prolonged disease course, a secondary B-cell neoplasm may arise in some patients, the most common example being the clonal evolution of CLL to diffuse large B-cell lymphoma, which is referred to as Richter transformation. Secondary de novo mature B-cell neoplasms arising in a patient with pre-existing CLL have been described; however, B-lymphoblastic leukemia (B-ALL) developing in untreated CLL is rare, and its clonal relationship to the primary neoplasm has been an interesting issue...
November 2016: Pathology, Research and Practice
Zongli Qi, Yuan Li, Jun Hu, Hua Guo, Xiangrong Zhao, Guanghua Wang, Jinwei Gao, Qiaoxia Hu
Immunoglobulin (Ig) and T-cell receptor (TCR) gene rearrangement (GR) studies have been successfully employed to investigate the clonality and cell lineage of various lymphoid malignancies. Several lymphoma cell lines, such as BJAB, RAJI, DG75 and Jurkat cell lines, were often used as the positive controls in GR detection assays. Of those, the DG75 B-cell lymphoma line was found to exhibit biclonality [two or more homoduplex and heteroduplex bands in a polymerase chain reaction (PCR) product of clonality assay] in the PCR of GR detection assays...
January 2013: Biomedical Reports
Jason Koshy, Tahereh Dadfornia, You-Wen Qian
Composite lymphoma (CL) refers to the presence of two or more distinct types of lymphomas in a single organ or tissue. CL is an infrequent finding and may be due to the existence of two genetically related neoplasms, i.e. transformation of a single lymphoma into another lymphoma, or be due to the presence of two clonally unrelated lymphomas. CL composed of more than two lymphomas is even rare. Herein we describe a case of diffuse large B-cell lymphoma (DLBCL) arising in a CL of follicular lymphoma (FL) and small lymphocytic lymphoma (SLL) in an inguinal lymph node of an 85 year old woman...
2014: International Journal of Clinical and Experimental Pathology
Zhongchuan W Chen, Ioanna Kotsikogianni, Jay S Raval, Christine G Roth, Marian A Rollins-Raval
Biclonal plasma cell myelomas producing two different isotypes of immunoglobulins are extremely rare entities; to date, the combination of IgD and IgM secretion by a biclonal plasma cell myeloma has not been reported. Bone marrow biopsy immunohistochemical studies in two cases revealed neoplastic plasma cells coexpressing IgD and IgM, but serum protein electrophoresis identified only the IgM monoclonal paraprotein in both cases. Biclonal plasma cell myelomas, while currently not well characterized in terms of their clinical behavior, should be distinguished from B-cell lymphoma with plasmacytic differentiation, given the different therapeutic implications...
2013: Case Reports in Hematology
Anurag Singh, Stephen Graziano, Neerja Vajpayee
Chronic lymphocytic leukemia (CLL) is by far the most common mature B-cell leukemia in Western countries. Some patients with CLL present with manifestations of extra medullary disease. We report a case of biclonal CLL/small lymphocytic lymphoma in an elderly patient who initially presented with skin lesions, no other systemic symptoms, and normal white cell count. Skin biopsy revealed concurrence of basal cell carcinoma and a nodular dermal infiltrate with immunophenotype consistent with CLL/small lymphocytic lymphoma...
March 2014: American Journal of Dermatopathology
Ayuko Taniguchi, Yumiko Hashida, Yuiko Nemoto, Takahiro Taguchi, Yoshihito Iwahara, Masanori Daibata
Pyothorax-associated lymphoma (PAL) is a representative form of diffuse large B-cell lymphoma associated with chronic inflammation, in which the Epstein-Barr virus (EBV) genome is consistently detectable in the lymphoma cells of all PAL cases. Cell lines and animal models would be useful for understanding better this rare lymphoma, but reports of PAL-derived cell lines are scarce. We report a new PAL cell line, designated Pal-2, with unique phenotypic expression. Pal-2 is the first PAL cell line that carries a biclonal EBV infection with abundant viral genome and that exhibits tumorigenic capacity once injected into nude mice...
November 2013: Leukemia Research
Leonardo Boiocchi, Rosanny Espinal Witter, Bing He, Shivakumar Subramaniyam, Susan Mathew, Kui Nie, Andrea Cerutti, Morton Coleman, Daniel M Knowles, Attilio Orazi, Wayne Tam
Composite lymphomas (CLs) consisting of 2 indolent B-cell lymphomas are rare. We present 2 CL cases composed of chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL), each with unique clinicopathologic features. In the first case, the FL was negative for IGH-BCL2 and harbored a novel IGH-associated translocation; in the second case, the CL manifested in the skin. The individual components in both CLs were derived from different B-cell clones. This is the first complete characterization, including molecular analysis, of CLs composed of leukemic CLL and FL and the first report of a cutaneous CL derived from 2 low-grade B cell lymphomas...
April 2012: American Journal of Clinical Pathology
Endi Wang, Evan Kulbacki, Maggie Stoecker
Waldenstrom macroglobulinemia and plasma cell myeloma are both mature B-cell neoplasms primarily involving bone marrow and frequently demonstrating paraproteinemia. Plasma cell myeloma has been described in association with other indolent B-cell lymphomas, particularly chronic lymphocytic leukemia, but concomitant Waldenstrom macroglobulinemia and plasma cell myeloma has not been previously described. We report the first case of sequential development of Waldenstrom macroglobulinemia and plasma cell myeloma over a 10-year period in a 73-year-old man with untreated IgM paraproteinemia...
July 2012: Human Pathology
Laura K Brockley, Kathryn L Heading, John E Jardine, Peter F Moore, Peter F Bennett
A 6-month-old female neutered domestic shorthair cat was examined for pain and swelling of the distal limbs. Swelling and malalignment of both carpi, dorsiflexion of the distal metatarsals and a mild, multicentric lymphadenopathy were detected on examination. Screening blood tests revealed a biclonal gammopathy, hypercalcemia and atypical leukocytes. Survey radiographs revealed lysis and proliferative changes within the physes. Multiple pathological physeal fractures were present, including the distal radii, metacarpal and metatarsal bones...
April 2012: Journal of Feline Medicine and Surgery
James T Edinger, Cynthia R Lorenzo, Debra L Breneman, Steven H Swerdlow
Primary cutaneous extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue (MALT) represents a monoclonal B-cell neoplasm that typically presents with papules, plaques or nodules. We describe a patient with a primary cutaneous MALT lymphoma with unusual clinical features and an unusual immunophenotype. Conventional microscopy together with immunohistochemistry and in-situ hybridization showed the presence of lymphoma in normal-appearing and minimally erythematous skin as well as in clinically involved skin...
September 2011: Journal of Cutaneous Pathology
Alison R Huppmann, Min-Ling Liu, Victor E Nava
The diagnoses of Hodgkin lymphoma and multiple myeloma have rarely been made simultaneously in the same patient. We present a case of an 82-year-old man who rapidly developed pancytopenia and liver failure with coagulopathy. Serum protein electrophoresis and immunofixation revealed an unequivocal immunoglobulin Gkappa and immunoglobulin Glambda biclonal gammopathy. Bone marrow biopsy showed involvement by classic Hodgkin lymphoma with an inflammatory background including 49% mature plasma cells. Unfortunately, the patient died 14 days after admission...
August 2010: Annals of Diagnostic Pathology
Takahiro Tsuji, Hiroshi Yamasaki, Nobuyuki Arima, Hiroyuki Tsuda
An 88-year-old female was admitted to our hospital due to a right breast tumor and biclonal gammopathy (IgG-lambda and IgA-lambda). CT scan showed systemic lymphadenopathy. Tumor specimens were comprised of medium-sized atypical lymphocytes. Lymphoepithelial lesions and plasmacytic differentiation were observed. The atypical lymphocytes were positive for CD20, CD79a, Bcl-2, CD5 and negative for CD10, Cyclin D1. Moreover, the cells expressed IgG-lambda or IgA-lambda. We diagnosed the patient's disease as lymphoplasmacytic lymphoma (LPL)...
April 2009: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Sharathkumar Bhagavathi, Mark A Micale, Vonda Douglas-Nikitin, Samer Ballouz, Kurt Neumann, Ann Marie Blenc
The simultaneous diagnosis of marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is rare. This study reports a patient with composite synchronous biclonal occurrence of MALT lymphoma of the lung and CLL/SLL. The morphology of the lung and peripheral blood showed features of MALT lymphoma and CLL, respectively. The cytogenetic evaluation of the lung specimen revealed a t(1;14) (p22;q32), a frequent genetic abnormality in MALT lymphoma...
June 2011: International Journal of Surgical Pathology
Yuichi Nakamura, Yasutaka Sato, Katsuhiko Yoshida, Emi Kakegawa, Yoshihiro Ito, Atsushi Seyama, Hidekazu Kayano, Masami Bessho
We report a follicular lymphoma (FL) case presenting the coexistence of two tumor cell subpopulations in lymph node (LN) and bone marrow (BM), which exhibited an inverse pattern of immunoglobulin light (IgL) chain gene rearrangement and expression: Igkappa-lambda+ in LN and Igkappa+lambda- in BM. These tumor clones shared an identical BCL2-IgH recombination, accompanying t(14;18)(q32;q21) translocation, and an identical variable, diversity and joining segments joining with clone-specific VH somatic hypermutations on the untranslocated IgH allele...
May 2009: European Journal of Haematology
Florian Rabiller, Marc-Antoine Belaud-Rotureau, Olivier Fitoussi, Pierre Dubus, Jean-Philippe Merlio, Antoine de Mascarel, Marie Parrens
We report the case of a 71-year-old woman presenting with composite lymphoma (CL) composed of a follicular lymphoma and a B-cell chronic lymphocytic leukemia. CL is a rare lymphoproliferative disorder, characterized by two distinct morphological and immunophenotypical patterns in the same anatomical site, most frequently of biclonal origin. This entity must be distinguished from transformation of low-grade lymphoma into high-grade lymphoma and from lymphoma with differentiation such as follicular lymphoma with marginal differentiation...
February 2008: Annales de Pathologie
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