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B‐Cell leukemia‐lymphoma with striking resemblance to burkitt lymphoma in a 70‐year‐old woman
Author(s) -
Shaw Michael T.,
Palmer Charles,
Yuhas John M.,
Rembe Armin,
Robertson Gerald,
Bankhurst Arthur D.
Publication year - 1978
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/ajh.2830050212
Subject(s) - vincristine , pathology , bone marrow , lymphoma , leukemia , medicine , burkitt's lymphoma , cyclophosphamide , biology , chemotherapy , immunology
A 70‐year‐old woman developed acute leukemia and a serum IgM spike. She entered complete remission with an adriamycin, vincristine, cytosine arabinoside, and prednisone combination. Bone marrow remission was maintained with intermittent cytosine arabinoside; however, she developed large skin nodules which partly remitted following adriamycin, vincristine, cyclophosphamide, and prednisone combination. They very rapidly recurred, and she died soon after. Autopsy revealed extensive tumor in the abdomen, pelvis, and thoracic cavity, but no bone marrow involvement. Histology revealed a “starry sky” appearance. Cytology showed undifferentiated cells with vacuolated cytoplasm resembling Burkitt lymphoma cells. Peroxidase and esterase stains were negative. There was strong pyroninophilia and the periodic acid‐Schiff reaction showed granular activity in the cytoplasm. Electron microscopic appearances also resembled Burkitt lymphoma. Cytogenetic studies were normal, with no Ph 1 chromosome. Immunofluorescence demonstrated surface IgM and a little IgA. 3 H‐thymidine incorporation was high, indicating rapid growth. Dibutyral cyclic adenosine monophosphate (cAMP) stimulated growth, which was further evidence of the lymphoid origin of the tumor. The close resemblance of this tumor to Burkitt lymphoma emphasizes the difficulties in systematically classifying the lymphomas.