Transformation of small B-cell lymphoma into large cell CD30⁺, CD4⁺, Epstein-Barr virus-negative lymphoma.

Publisher: College of American Pathologists Country of Publication: United States NLM ID: 7607091 Publication Model: Print Cited Medium: Internet ISSN: 1543-2165 (Electronic) Linking ISSN: 00039985 NLM ISO Abbreviation: Arch Pathol Lab Med Subsets: MEDLINE

Publication: Northfield, Ill. : College of American Pathologists
Original Publication: Chicago, American Medical Assn.

Cell Transformation, Neoplastic* ; Gene Rearrangement, B-Lymphocyte*; Leukemia, Lymphocytic, Chronic, B-Cell/*diagnosis ; Lymphoma, Large B-Cell, Diffuse/*diagnosis; Biomarkers/metabolism ; Biopsy ; CD4 Antigens/metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Ki-1 Antigen/metabolism ; Leukemia, Lymphocytic, Chronic, B-Cell/genetics ; Leukemia, Lymphocytic, Chronic, B-Cell/metabolism ; Leukemia, Lymphocytic, Chronic, B-Cell/pathology ; Lymphoma, Follicular/diagnosis ; Lymphoma, Follicular/genetics ; Lymphoma, Follicular/metabolism ; Lymphoma, Follicular/pathology ; Lymphoma, Large B-Cell, Diffuse/genetics ; Lymphoma, Large B-Cell, Diffuse/metabolism ; Lymphoma, Large B-Cell, Diffuse/pathology ; Lymphoma, Large-Cell, Anaplastic/diagnosis ; Lymphoma, Large-Cell, Anaplastic/genetics ; Lymphoma, Large-Cell, Anaplastic/metabolism ; Lymphoma, Large-Cell, Anaplastic/pathology ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Proteins/metabolism ; Proto-Oncogene Proteins c-bcl-2/genetics ; Proto-Oncogene Proteins c-bcl-2/metabolism

We report here 2 separate cases in which patients with known low-grade B-cell lymphomas presented with transformed lesions that were CD30⁺, CD4⁺, Epstein-Barr virus negative, and negative or focally weak for a wide range of B-cell, T-cell, and histiocytic/dendritic cell markers. In each case the transformed lymphoma possessed an identical pattern of immunoglobulin heavy chain and/or BCL2 rearrangement to the corresponding original low-grade B-cell lymphoma, confirming their identity as transformed B-cell lymphoma. A review of the relevant literature reveals that, to our knowledge, no transformed B-cell lymphomas with this immunophenotype have been previously reported, which creates the opportunity for potential errors of diagnosis. These cases highlight the importance of correlation with the patient's history and with molecular genetic results in rendering an accurate diagnosis.

0 (Biomarkers)
0 (CD4 Antigens)
0 (Ki-1 Antigen)
0 (Neoplasm Proteins)
0 (Proto-Oncogene Proteins c-bcl-2)

Date Created: 20140731 Date Completed: 20140926 Latest Revision: 20171116

20250114

10.5858/arpa.2013-0089-CR

25076300