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Multiple lymphoid nodules in bone marrow have the same clonality as underlying myelodysplastic syndrome recognized with fluorescent in situ hybridization technique
Author(s) -
Mongkonsritragoon Wichean,
Letendre Louis,
Li ChinYang
Publication year - 1998
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/(sici)1096-8652(199811)59:3<252::aid-ajh14>3.0.co;2-c
Subject(s) - bone marrow , pathology , cytopenia , fluorescence in situ hybridization , myelodysplastic syndromes , lymphoma , biology , immunophenotyping , medicine , immunology , antigen , biochemistry , chromosome , gene
Benign nodular lymphoid lesions are not rare in the bone marrow of patients with myelodysplastic syndrome (MDS). Herein, we report a case of MDS with clonal lymphoid aggregates in the bone marrow but without evidence of systemic lymphoma. The case of a 71‐year‐old man was evaluated for cytopenia. His bone marrow was initially hypocellular, with 10% blasts and a few small lymphoid aggregates. The diagnosis of refractory anemia with excess blasts was made. The disease progressed gradually, and he received erythropoietin and granulocyte colony‐stimulating factor for a short time. Forty‐two months later, acute leukemia (M1) developed, with 60% to 70% blasts in the bone marrow. The bone marrow also showed large aggregates of lymphocytes. Immunohistochemical study of these cells in the nodular lesions showed 50% CD3+ and 50% CD20+. Cytogenetic and molecular genetic studies revealed monosomy 7 and T‐ and B‐cell clonal gene rearrangement. Fluorescent in situ hybridization study with centromere‐specific probes of a bone marrow specimen showed monosomy 7 in both nodular lymphoid lesions and surrounding bone marrow cells, indicating that both processes originated from the same abnormal pluripotential progenitor. Am. J. Hematol. 59:252–257, 1998. © 1998 Wiley‐Liss, Inc.