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Composite T lymphoblastic leukemia/lymphoma and diffuse large B‐cell lymphoma: Case report
Author(s) -
Niino Daisuke,
Ohsaki Koichi,
Arakawa Fumiko,
Watanabe Jiro,
Kimura Yoshizo,
Kiyasu Junichi,
Takeuchi Masanori,
Miyoshi Hiroaki,
Yoshida Maki,
Sugita Yasuo,
Ohshima Koichi,
Okamura Takashi
Publication year - 2011
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2011.02662.x
Subject(s) - lymphoblastic lymphoma , lymphoma , vincristine , pathology , terminal deoxynucleotidyl transferase , diffuse large b cell lymphoma , cd20 , immunophenotyping , medicine , cyclophosphamide , immunology , immunohistochemistry , t cell , antigen , chemotherapy , immune system , tunel assay
This report concerns a unique case of a composite lymphoma composed of T‐lymphoblastic leukemia/lymphoma (T‐LBL) and diffuse large B‐cell lymphoma (DLBCL) in a 72‐year‐old woman with generalized lymphadenopathy, splenomegaly and ascites. Laboratory findings showed increased lactate dehydrogenase and soluble interleukin‐2 receptor. The biopsy specimen showed replacement of the normal architecture of the lymph nodes by a tumor containing a dual cell population composed of large lymphocytes and medium‐sized lymphocytes. Sheets of large lymphocytes often were punctuated by clusters of medium‐sized lymphocytes. Flow cytometry and immunohistochemical analysis showed a composite lymphoma with both T‐LBL and DLBCL. The T‐LBL expressed CD1a, CD3, CD4, CD8, and terminal deoxynucleotidyl transferase. The DLBCL expressed CD19 and CD20, CD23, bcl‐2, bcl‐6, MUM1 and immunoglobulin κ light chain. Polymerase chain reaction detected a monoclonal pattern of T‐cell receptor γ and immunoglobulin heavy chain rearrangements in the same specimen. She received eight cycles of R‐CHOP (rituximab+cyclophosphamide, doxorubicin, vincristine, prednisone) therapy and achieved complete remission. She has shown no signs of recurrence 20 months after the diagnosis. We describe here a very unusual and, to the best of our knowledge, an as yet never reported case of a primary composite lymphoma of T‐LBL and DLBCL.