Assuntos
Linfoma de Burkitt/patologia , Linfoma Composto/patologia , Linfoma Difuso de Grandes Células B/patologia , Idoso , Antígenos CD20/análise , Linfoma de Burkitt/metabolismo , Células Clonais/química , Células Clonais/patologia , Linfoma Composto/metabolismo , Evolução Fatal , Humanos , Imuno-Histoquímica , Linfoma Difuso de Grandes Células B/metabolismo , MasculinoRESUMO
Anaplastic large cell lymphoma and small lymphocytic lymphoma are two lymphoid malignancies with completely distinct morphologies and natural histories. We present a rare case of composite anaplastic large cell lymphoma and small lymphocytic lymphoma in an inguinal lymph node of an otherwise healthy 47-year-old male patient. Immunohistochemical and molecular studies identified the two populations clearly. Their separation is imperative as anaplastic large cell lymphoma can be an aggressive neoplasm and easily overlooked in cases of small lymphocytic lymphoma with a small population of anaplastic large cell lymphoma cells.
Assuntos
Biomarcadores Tumorais/metabolismo , Linfoma Composto/patologia , Leucemia Linfocítica Crônica de Células B/patologia , Linfonodos/patologia , Linfoma Anaplásico de Células Grandes/patologia , Quinase do Linfoma Anaplásico , Linfoma Composto/diagnóstico por imagem , Linfoma Composto/metabolismo , DNA de Neoplasias/genética , Diagnóstico Diferencial , Virilha , Humanos , Imuno-Histoquímica , Leucemia Linfocítica Crônica de Células B/diagnóstico por imagem , Leucemia Linfocítica Crônica de Células B/metabolismo , Linfoma Anaplásico de Células Grandes/diagnóstico por imagem , Linfoma Anaplásico de Células Grandes/metabolismo , Masculino , Pessoa de Meia-Idade , Radiografia , Receptores Proteína Tirosina Quinases/genéticaRESUMO
Composite lymphoma with follicular lymphoma (FL) and mantle cell lymphoma (MCL) components is rare and can pose a substantial diagnostic challenge. We report two cases of composite lymphoma with FL and MCL components occurring in lymph nodes. Both cases showed near total effacement of the lymph node architecture by grade 1 FL (CD10+ and BCL2+) with accompanying in situ MCL component (CD5+ and cyclin D1+) surrounding neoplastic follicles. The diagnosis of composite FL and MCL was confirmed by detecting the t(14;18)(q32;q21) and t(11;14)(q13;q32) in the FL and MCL components, respectively. Immunoglobulin heavy chain fragment length analysis in both cases showed identical dominant monoclonal peaks in microdissected neoplastic lymphoid cells from FL and MCL components. These findings suggest a common clonal origin for the FL and MCL components in both cases.
Assuntos
Linfoma Composto/patologia , Linfoma Folicular/patologia , Linfoma de Célula do Manto/patologia , Idoso , Idoso de 80 Anos ou mais , Antígenos CD/genética , Antígenos CD/metabolismo , Linfoma Composto/genética , Linfoma Composto/metabolismo , Ciclina D1/genética , Ciclina D1/metabolismo , Feminino , Humanos , Cadeias Pesadas de Imunoglobulinas/genética , Cadeias Pesadas de Imunoglobulinas/metabolismo , Linfonodos/metabolismo , Linfonodos/patologia , Linfoma Folicular/genética , Linfoma Folicular/metabolismo , Linfoma de Célula do Manto/genética , Linfoma de Célula do Manto/metabolismo , MasculinoRESUMO
Composite lymphoma of T-cell and B-cell type is uncommon, and the one occurring primarily on skin is extremely rare. Herein, we report a unique case of composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient. The patient presented with multiple erythematous patches, plaques, and nodules on the upper arms, scalp, and trunk. Four punch biopsies of arm and scalp lesions demonstrated lymphoid infiltrate in superficial to deep dermis with a characteristic zone distribution of T-cell and B-cell components. T cells were distributed in papillary and perifollicular dermis and displayed a larger size with convoluted nuclei, whereas B cells were small sized, assuming nodular infiltrate in mid-deep dermis with coexpression of CD5. Molecular test detected clonal rearrangement of both TCRG and IGH/K genes with identical amplicons for each gene in all 4 biopsies. Clinical staging revealed no extracutaneous lesions. A multidisplinary approach is emphasized to establish a definitive diagnosis.
Assuntos
Linfoma Composto/patologia , Linfoma de Células B/patologia , Micose Fungoide/patologia , Neoplasias Cutâneas/patologia , Idoso , Linfócitos B/metabolismo , Linfócitos B/patologia , Biomarcadores Tumorais/metabolismo , Antígenos CD5/metabolismo , Células Clonais , Terapia Combinada , Linfoma Composto/genética , Linfoma Composto/metabolismo , Linfoma Composto/terapia , Rearranjo Gênico , Genes Codificadores da Cadeia gama de Receptores de Linfócitos T , Humanos , Imunoglobulinas/genética , Linfoma de Células B/genética , Linfoma de Células B/metabolismo , Linfoma de Células B/terapia , Masculino , Micose Fungoide/genética , Micose Fungoide/metabolismo , Micose Fungoide/terapia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/terapia , Linfócitos T/metabolismo , Linfócitos T/patologia , Resultado do TratamentoRESUMO
This report describes a 60-year-old man with concurrent gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and classical Hodgkin lymphoma (CHL). Atypical, medium-sized, lymphoid cells proliferated in the mucosa to muscular layer of the stomach showing a lymphoepithelial lesion; admixed with Hodgkin/Reed-Sternberg (HRS) cells and an inflammatory cell background. MALT lymphoma cells expressed CD20, CD79a, PAX5, and BOB.1, and HRS cells expressed CD30, CD15, Epstein-Barr virus-encoded RNA, and EBV-latent membrane protein 1. Only CHL invaded into the regional lymph nodes. Two possibilities of transformation of MALT lymphoma into CHL and de novo CHL within MALT lymphoma are discussed.
Assuntos
Linfoma Composto/patologia , Doença de Hodgkin/patologia , Linfoma de Zona Marginal Tipo Células B/patologia , Segunda Neoplasia Primária , Neoplasias Gástricas/patologia , Idoso , Biomarcadores Tumorais/metabolismo , Transformação Celular Neoplásica , Terapia Combinada , Linfoma Composto/metabolismo , Linfoma Composto/terapia , Evolução Fatal , Mucosa Gástrica/patologia , Doença de Hodgkin/metabolismo , Doença de Hodgkin/terapia , Humanos , Linfoma de Zona Marginal Tipo Células B/metabolismo , Linfoma de Zona Marginal Tipo Células B/terapia , Masculino , Invasividade Neoplásica , Células de Reed-Sternberg/patologia , Neoplasias Gástricas/metabolismoRESUMO
Composite lymphoma (CL) is a rare occurrence of 2 or more morphologically and immunophenotypically distinct lymphoma clones in a single anatomic site. A retrospective analysis of 1,722 solid tissue samples clinically suggestive of lymphoma was carried out in our institute during a 12-year period to evaluate the efficacy of flow cytometry (FC) in identifying CL. We report 17 CL cases. A strong correlation between morphologic findings and FC was observed in 13 cases (76%). In the 4 cases diagnosed as non-Hodgkin lymphoma plus Hodgkin lymphoma, although FC did not detect Reed-Sternberg cells, it accurately identified the neoplastic B- or T-cell component. In 3 cases, FC indicated the need to evaluate an additional neoplastic component that was not morphologically evident. Our data demonstrate that FC immunophenotyping of tissues may enhance the performance of the diagnostic morphologic evaluation of CL. To the best of our knowledge, this is the first report in the literature of a wide series of CL studied also by FC.