1
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Moalem KN, Alderuccio JP, Bommier C, Habermann T, Link BK, Cerhan JR, Florindez J, Lossos IS. Transformation of marginal zone lymphoma to Hodgkin lymphoma. Blood Adv 2024; 8:4559-4562. [PMID: 39024508 PMCID: PMC11399613 DOI: 10.1182/bloodadvances.2024013434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/20/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024] Open
Affiliation(s)
- Kamilia N Moalem
- Department of Medicine, University of Miami and Jackson Memorial Hospital, Miami, FL
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, University of Miami and Sylvester Comprehensive Cancer Center, Miami, FL
| | - Côme Bommier
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Thomas Habermann
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Brian K Link
- Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - James R Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Jorge Florindez
- Division of Hematology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, University of Miami and Sylvester Comprehensive Cancer Center, Miami, FL
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2
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Trecourt A, Donzel M, Fontaine J, Ghesquières H, Jallade L, Antherieu G, Laurent C, Mauduit C, Traverse-Glehen A. Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review. Cancers (Basel) 2022; 14:cancers14225695. [PMID: 36428786 PMCID: PMC9688742 DOI: 10.3390/cancers14225695] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
The co-occurrence of several lymphomas in a patient defines composite/synchronous lymphoma. A common cellular origin has been reported for both contingents of such entities. In the present review, we aimed to gather the available data on composite lymphomas associating a classical Hodgkin lymphoma (cHL) with another lymphoma, to better understand the plasticity of mature B and T-cells. This review highlights that >70% of patients with a composite lymphoma are ≥55 years old, with a male predominance. The most reported associations are cHL with follicular lymphoma or diffuse large B-cell lymphoma, with over 130 cases reported. The cHL contingent is often of mixed cellularity type, with a more frequent focal/weak CD20 expression (30% to 55.6%) compared to de novo cHL, suggesting a particular pathophysiology. Moreover, Hodgkin cells may express specific markers of the associated lymphoma (e.g., BCL2/BCL6 for follicular lymphoma and Cyclin D1 for mantle cell lymphoma), sometimes combined with common BCL2/BCL6 or CCND1 rearrangements, respectively. In addition, both contingents may share similar IgH/IgK rearrangements and identical pathogenic variants, reinforcing the hypothesis of a common clonal origin. Finally, cHL appears to be endowed with a greater plasticity than previously thought, supporting a common clonal origin and a transdifferentiation process during lymphomagenesis of composite lymphomas.
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Affiliation(s)
- Alexis Trecourt
- Service de Pathologie Multi-Site, Site Sud, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- Faculté de Médecine Lyon-Sud, Université Claude Bernard Lyon 1, UR 3738—CICLY, 69921 Oullins, France
- Correspondence: ; Tel.: +33-(0)4-7886-1186; Fax: +33-(0)4-7886-5713
| | - Marie Donzel
- Service de Pathologie Multi-Site, Site Sud, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- Faculté de Médecine de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Faculté de Médecine Lyon-Sud, CRCL, Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon-1, INSERM U1111, CNRS, UMR5308, ENS Lyon, 69921 Oullins, France
| | - Juliette Fontaine
- Service de Pathologie Multi-Site, Site Sud, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Hervé Ghesquières
- Faculté de Médecine de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Faculté de Médecine Lyon-Sud, CRCL, Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon-1, INSERM U1111, CNRS, UMR5308, ENS Lyon, 69921 Oullins, France
- Service d’Hématologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Laurent Jallade
- Faculté de Médecine de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Faculté de Médecine Lyon-Sud, CRCL, Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon-1, INSERM U1111, CNRS, UMR5308, ENS Lyon, 69921 Oullins, France
- Laboratoire d’Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Gabriel Antherieu
- Service d’Hématologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Camille Laurent
- Service de Pathologie, Centre de Recherche en Cancérologie de Toulouse-Purpan, Institut Universitaire du Cancer, Oncopole de Toulouse, 31100 Toulouse, France
| | - Claire Mauduit
- Service de Pathologie Multi-Site, Site Sud, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- Faculté de Médecine de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Institut National de la Santé et de la Recherche Médicale, Centre Méditerranéen de Médecine Moléculaire (C3M), Unité 1065, Equipe 10, 06000 Nice, France
| | - Alexsandra Traverse-Glehen
- Service de Pathologie Multi-Site, Site Sud, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
- Faculté de Médecine de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Faculté de Médecine Lyon-Sud, CRCL, Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon-1, INSERM U1111, CNRS, UMR5308, ENS Lyon, 69921 Oullins, France
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3
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Blaise B, Wilson ML, Guitart J. Hodgkin and Reed-Sternberg-like cells within a recurrent primary cutaneous marginal zone lymphoma. J Cutan Pathol 2020; 48:716-718. [PMID: 33216406 DOI: 10.1111/cup.13921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/26/2020] [Accepted: 11/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Brittany Blaise
- Division of Dermatology, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Morgan L Wilson
- Division of Dermatology, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Joan Guitart
- Department of Dermatology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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4
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Parente P, Zanelli M, Sanguedolce F, Mastracci L, Graziano P. Hodgkin Reed-Sternberg-Like Cells in Non-Hodgkin Lymphoma. Diagnostics (Basel) 2020; 10:E1019. [PMID: 33261174 PMCID: PMC7760963 DOI: 10.3390/diagnostics10121019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022] Open
Abstract
Reed-Sternberg cells (RSCs) are hallmarks of classic Hodgkin lymphoma (cHL). However, cells with a similar morphology and immunophenotype, so-called Reed-Sternberg-like cells (RSLCs), are occasionally seen in both B cell and T cell non-Hodgkin Lymphomas (NHLs). In NHLs, RSLCs are usually present as scattered elements or in small clusters, and the typical background microenviroment of cHL is usually absent. Nevertheless, in NHLs, the phenotype of RSLCs is very similar to typical RSCs, staining positive for CD30 and EBV, and often for B cell lineage markers, and negative for CD45/LCA. Due to different therapeutic approaches and prognostication, it is mandatory to distinguish between cHL and NHLs. Herein, NHL types in which RSLCs can be detected along with clinicopathological correlation are described. Moreover, the main helpful clues in the differential diagnosis with cHL are summarized.
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Affiliation(s)
- Paola Parente
- Pathology Unit, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (P.P.); (P.G.)
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy;
| | | | - Luca Mastracci
- Anatomic Pathology, Ospedale Policlinico San Martino IRCCS, 16132 Genova, Italy;
- Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, 16132 Genova, Italy
| | - Paolo Graziano
- Pathology Unit, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (P.P.); (P.G.)
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5
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Leus HJ, Robin V, Molina TJ, Forsyth R, Dehou MF. [Marginal zone lymphoma associated with Reed-Sternberg cells: A challenge for the pathologist]. Ann Pathol 2020; 41:212-215. [PMID: 32798091 DOI: 10.1016/j.annpat.2020.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/07/2020] [Accepted: 06/21/2020] [Indexed: 10/23/2022]
Abstract
We report the case of a 46-year-old male patient presenting with a Claude Bernard-Horner Syndrome. Clinical evaluation showed a clonal B-cell population, lambda restricted. PET-scan captured femoral and axillary lymph nodes. Therefore the diagnosis of a marginal zone lymphoma was posted for which an attitude of watchful waiting was suggested. Eighteen months later, the patient developed an inguinal adenopathy. This lymph node led to the diagnosis of a nodular sclerosing Hodgkin lymphoma. Initial treatment with ABVD showed a good response, but the patient relapsed after eight months. A second biopsy confirmed the diagnosis of a marginal zone lymphoma but also identified giant Reed-Sternberg cells, (CD15+, CD30+ and CD20+). The initial biopsy was revised. This last diagnosis of a nodal marginal zone lymphoma with presence of Reed-Sternberg cells is rarely described in the literature. Several scientific theories can be found. Some cases described a transformation of non-Hodgkin lymphoma that presented Reed-Sternberg cells, other cases mentioned a collision or composite tumor. An accidental finding of Reed-Sternberg cells can be seen by after an infectious disease such as EBV. The presence of only Reed-Sternberg cells in a non-Hodgkin lymphoma is not sufficient to make a diagnosis of collision tumor.
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Affiliation(s)
- Hans Jean Leus
- Centre de morphologie pathologique, Cerba Path, Anderlecht, Belgique; Département de pathologie, universitair ziekenhuis Brussel, Vrije universiteit Brussel, Brussel, Belgique.
| | - Valérie Robin
- Département d'hématologie, grand hôpital de Charleroi, Charleroi, Belgique
| | - Thierry J Molina
- Département de pathologie, université de Paris, hôpital universitaire Necker-Enfants malades, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Ramses Forsyth
- Département de pathologie, universitair ziekenhuis Brussel, Vrije universiteit Brussel, Brussel, Belgique
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6
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Hirji SH, Maeng MM, Tooley AA, Soderquist C, Annunziata J, Kazim M. Orbital marginal cell lymphoma and mantle cell lymphoma subclone in patient with monoclonal gammopathy of unknown significance. Orbit 2020; 40:247-251. [PMID: 32363993 DOI: 10.1080/01676830.2020.1760312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Indolent lymphomas have the potential to transform into more aggressive phenotypes. This phenomenon is best exemplified by the transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma into diffuse large B-cell lymphoma. However, it is less common to find multiple small cell lymphomas in the orbit, particularly mantle cell lymphoma. We present a case of an extranodal marginal zone lymphoma arising in the orbit that acquired a subclonal t(11;14) (q13;32) CCND1-IGH translocation, giving rise to a subclone of mantle cell lymphoma. The management of this tumor was targeted towards the more aggressive mantle cell subclone. The tumor exhibited an incomplete response to rituximab alone. To the best of the authors' knowledge, this represents the first such case to be described irrespective of site of origin.
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Affiliation(s)
- Sitara H Hirji
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michelle M Maeng
- Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA
| | - Andrea A Tooley
- Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA
| | - Craig Soderquist
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Joseph Annunziata
- Department of Pathology & Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Michael Kazim
- Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA
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7
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Dotlic S, Ponzoni M, King RL, Oschlies I, Ferry J, Calaminici M, Montes-Moreno S, Goodlad JR, Ott G, Traverse-Glehen A. The broad and challenging landscape of extranodal lymphoproliferations. Virchows Arch 2019; 476:633-646. [DOI: 10.1007/s00428-019-02702-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/26/2022]
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8
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Völker HU, Becker E, Müller-Hermelink HK, Scheich M. [Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region]. HNO 2019; 68:32-39. [PMID: 31712877 DOI: 10.1007/s00106-019-00781-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Extranodal lymphomas occurring in the head and neck region account for 12-15% of all malignant tumors of this locality. Classical Hodgkin lymphoma (cHL) is a rare subtype, representing around 1% of all lymphomas in Waldeyer's ring. Cases diagnosed in the Reference Centre for Lymph Node Pathology at the Pathological Institute of the University of Würzburg were further analyzed in this study. MATERIALS AND METHODS Histological subtype and EBV association of 21 cases were reviewed in conjunction with clinical data. RESULTS Data of 12 male and 9 female patients with an average age of 51 years (median 45; 35-72) were reviewed. All samples were taken from the lymphatic tissue of the Waldeyer's ring (nasopharynx n = 15, palatine tonsils n = 5, lingual tonsils n = 1). The most common symptoms leading to a consultation with an otorhinolaryngologist were otalgia, swelling, or impaired nasal breathing. Only four patients showed typical B‑symptoms. In 6 cases (29%), an isolated extranodal manifestation was found, 15 patients (71%) showed simultaneous infiltration of cervical lymph nodes during staging, and 6 cases (29%) were EBV positive. CONCLUSION An exclusively extranodal manifestation of cHL in Waldeyer's ring is rare, whereas infiltration of extranodal tissue in the case of a primary manifestation of lymphoma in cervical nodes can occur more frequently and may often remain undiagnosed. Therefore, a specialized ENT consultation could be a reasonable complementary module in tumor staging to determine the correct tumor extent.
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Affiliation(s)
- H-U Völker
- Pathologie, Leopoldina Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Deutschland
| | - E Becker
- Pathologie, Leopoldina Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Deutschland
| | | | - M Scheich
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland.
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9
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Concurrent mucosa-associated lymphoid tissue lymphoma with diffuse large B-cell lymphoma transformation and Hodgkin lymphoma of the neck. Ann Hematol 2018; 97:1089-1094. [PMID: 29427189 DOI: 10.1007/s00277-018-3271-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/31/2018] [Indexed: 10/18/2022]
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10
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Pathology of nodal marginal zone lymphomas. Best Pract Res Clin Haematol 2017; 30:50-55. [DOI: 10.1016/j.beha.2016.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 11/25/2016] [Indexed: 11/20/2022]
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11
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Amitay-Laish I, Tavallaee M, Kim J, Hoppe R, Million L, Feinmesser M, Fenig E, Wolfe M, Hodak E, Kim Y. Paediatric primary cutaneous marginal zone B-cell lymphoma: does it differ from its adult counterpart? Br J Dermatol 2017; 176:1010-1020. [DOI: 10.1111/bjd.14932] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/13/2022]
Affiliation(s)
- I. Amitay-Laish
- Department of Dermatology; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - M. Tavallaee
- Department of Dermatology; Stanford Cancer Center; Stanford CA U.S.A
| | - J. Kim
- Department of Pathology; Stanford Cancer Center; Stanford CA U.S.A
| | - R.T. Hoppe
- Department of Radiation Oncology; Stanford Cancer Center; Stanford CA U.S.A
| | - L. Million
- Department of Radiation Oncology; Stanford Cancer Center; Stanford CA U.S.A
| | - M. Feinmesser
- Department of Pathology; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - E. Fenig
- Department of Radiotherapy Unit; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - M.E.L. Wolfe
- Department of Dermatology; Stanford Cancer Center; Stanford CA U.S.A
| | - E. Hodak
- Department of Dermatology; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Y.H. Kim
- Department of Dermatology; Stanford Cancer Center; Stanford CA U.S.A
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12
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Casulo C, Friedberg J. Transformation of marginal zone lymphoma (and association with other lymphomas). Best Pract Res Clin Haematol 2016; 30:131-138. [PMID: 28288708 DOI: 10.1016/j.beha.2016.08.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/02/2016] [Accepted: 08/04/2016] [Indexed: 12/18/2022]
Abstract
Marginal zone lymphomas (MZL) are a diverse group of indolent lymphoproliferative disorders that comprise three subtypes: nodal, splenic and mucosal associated marginal zone lymphomas (MALT). Histologic transformation (HT) to an aggressive lymphoma is a rare event that can occur in any subtype, and at lower frequency compared to other indolent non Hodgkin lymphomas (NHL) like follicular lymphoma. There are few data directly associated with risk and prognosis of transformation in MZL. However, recent advances in the understanding of molecular and genetic features of MALT have contributed to an evolving appreciation of HT in this disease. Optimal treatment of HT of MZL remains unknown. Much of the approach to managing transformed MZL is extrapolated from other indolent NHLs.
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Affiliation(s)
- Carla Casulo
- Wilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA.
| | - Jonathan Friedberg
- Wilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA.
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13
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Lymphoma Heterogeneity: Three Different Histological Pictures and One Unique Clone. Case Rep Hematol 2016; 2016:3947510. [PMID: 27867670 PMCID: PMC5102716 DOI: 10.1155/2016/3947510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/07/2016] [Accepted: 09/19/2016] [Indexed: 12/17/2022] Open
Abstract
We report a patient who developed up to three different lymphomas with the same clonal IGH rearrangement. She was first diagnosed of splenic zone marginal lymphoma and relapsed for the first time with Hodgkin lymphoma histology and later with diffuse large B-cell lymphoma histology. Subsequent biopsies and analysis of clonally rearranged IGH genes helped to elucidate the clonal relationship between the three histologies and to confirm a common origin from the three tissue histologies. An integrated diagnosis should always be performed in order to achieve the most accurate diagnosis and be able to choose the best therapeutic options for our patients.
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14
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Maeshima AM, Taniguchi H, Nomoto J, Makita S, Kitahara H, Fukuhara S, Munakata W, Suzuki T, Maruyama D, Kobayashi Y, Tobinai K. Clinicopathological features of classical Hodgkin lymphoma in patients ≥40 years old, with special reference to composite cases. Jpn J Clin Oncol 2015. [DOI: 10.1093/jjco/hyv101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Pediatric composite nodal marginal zone lymphoma and classical Hodgkin lymphoma. J Hematop 2014. [DOI: 10.1007/s12308-014-0215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Wobser M, Kerstan A, Kneitz H, Goebeler M, Kunzmann V, Rosenwald A, Geissinger E. Primary cutaneous marginal zone lymphoma with sequential development of nodal marginal zone lymphoma in a patient with selective immunoglobulin A deficiency. J Cutan Pathol 2013; 40:1035-41. [PMID: 24274426 DOI: 10.1111/cup.12230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 08/06/2013] [Accepted: 09/03/2013] [Indexed: 12/22/2022]
Abstract
Multiple lymphoma subtypes occurring within one patient is rare in the context of B-cell lymphoma, and only few such cases have been reported in association with primary cutaneous marginal zone lymphoma (PCMZL). We herein describe the case of a 43-year-old patient who was diagnosed with PCMZL and subsequently developed a clonally unrelated nodal marginal zone lymphoma (MZL). At the time of diagnosis of PCMZL, multiple skin lesions were present. The atypical lymphoid infiltrate showed monotypic expression of immunoglobulin light chain lambda and heavy chain (IgM) on immunohistochemistry and an identical B-cell clone. No sign of systemic lymphoma was present in staging examinations. Complete remission was achieved utilizing rituximab. After a 3-year clinical course of repetitive cutaneous relapses and remissions, the patient additionally developed nodal lymphoma involvement by MZL which, however, harbored an immunophenotype and a genetic clone distinct from the cutaneous lymphoma counterpart. Therefore, the rare occurrence of two different types of MZL with sequential evolution was diagnosed. In this uncommon case, we hypothesize that selective immunoglobulin A deficiency may play a promoting role for the metachronous development of the two MZL that occurred in our patient.
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Affiliation(s)
- Marion Wobser
- Department of Dermatology, University Clinic Wuerzburg, Wuerzburg, Germany
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17
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Wang HW, Yang W, Wang L, Lu YL, Lu JY. Composite diffuse large B-cell lymphoma and classical Hodgkin’s lymphoma of the stomach: Case report and literature review. World J Gastroenterol 2013; 19:6304-6309. [PMID: 24115832 PMCID: PMC3787365 DOI: 10.3748/wjg.v19.i37.6304] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 07/22/2013] [Accepted: 08/20/2013] [Indexed: 02/06/2023] Open
Abstract
The combination of classical Hodgkin’s lymphoma (cHL) and non-Hodgkin lymphoma coexisting in the same patient is not common, especially in one extranodal location. Here we present a rare case of composite diffuse large B-cell lymphoma (DLBCL) and cHL occurring simultaneously in the stomach of a 53-year-old female who presented with upper abdominal discomfort and gas pain. Surgery was performed and the disease was diagnosed pathologically as composite lymphoma of DLBCL and cHL using hematoxylin-eosin and immunohistochemical staining. Epstein-Barr virus (EBV) infection was not detected by in situ hybridization for EBV-encoded RNA or immunohistochemistry for EBV latent membrane protein-1. Polymerase chain reaction analysis from the two distinct components of the tumor demonstrated clonal immunoglobulin κ light chain gene rearrangements. The patient died approximately 11 mo after diagnosis in spite of receiving eight courses of the CHOP and two courses of the rituximab-CHOP (RCHOP) chemotherapy regimen. This case report showed that the two distinct components, DLBCL and cHL, appeared to originate from the same clonal progenitor cell, and that EBV infection was not essential for transformation during the course of tumorigenesis.
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MESH Headings
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biopsy
- Chemotherapy, Adjuvant
- Composite Lymphoma/chemistry
- Composite Lymphoma/genetics
- Composite Lymphoma/pathology
- Composite Lymphoma/therapy
- Fatal Outcome
- Female
- Gastrectomy
- Hodgkin Disease/genetics
- Hodgkin Disease/metabolism
- Hodgkin Disease/pathology
- Hodgkin Disease/therapy
- Humans
- Immunohistochemistry
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Middle Aged
- Stomach Neoplasms/chemistry
- Stomach Neoplasms/genetics
- Stomach Neoplasms/pathology
- Stomach Neoplasms/therapy
- Treatment Outcome
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Servitje O, Muniesa C, Benavente Y, Monsálvez V, Garcia-Muret MP, Gallardo F, Domingo-Domenech E, Lucas A, Climent F, Rodriguez-Peralto JL, Ortiz-Romero PL, Sandoval J, Pujol RM, Estrach MT. Primary cutaneous marginal zone B-cell lymphoma: response to treatment and disease-free survival in a series of 137 patients. J Am Acad Dermatol 2013; 69:357-65. [PMID: 23796549 DOI: 10.1016/j.jaad.2013.04.047] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/23/2013] [Accepted: 04/25/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Primary cutaneous marginal zone B-cell lymphomas are low-grade lymphomas running an indolent course. Skin relapses have been frequently reported but little information about disease-free survival (DFS) is available. OBJECTIVE We sought to evaluate relapse rate and DFS in patients with primary cutaneous marginal zone B-cell lymphomas. METHODS Clinical features, European Organization for Research and Treatment of Cancer/International Society for Cutaneous Lymphomas stage, light chain restriction, clonality, treatments, skin relapses, DFS, stage progression, extracutaneous disease, and outcome are analyzed in a series of 137 patients. RESULTS Patients were classified as solitary lesion (T1) (n = 70; 51%), regional skin involvement (T2) (n = 40; 29%), and generalized skin lesions (T3) (n = 27; 20%). Surgical excision, local radiotherapy, or a combination were the initial treatment in 118 patients (86%). In 121 of 137 patients (88%) a complete remission was observed after initial treatment, including 99 of 106 patients (93%) with solitary or localized disease and 22 of 31 patients (71%) with multifocal lesions. Cutaneous relapses were observed in 53 patients (44%). Median DFS was 47 months. Patients with multifocal lesions or T3 disease showed higher relapse rate and shorter DFS. No significant differences were observed between surgery and radiotherapy, but surgery alone was associated with more recurrences at initial site. Overall survival at 5 and 10 years was 93%. Six patients (4%) developed extracutaneous disease during follow-up. LIMITATIONS This was a case series retrospective study. CONCLUSION Our results support long-term follow-up in patients with primary cutaneous marginal zone B-cell lymphomas. Disseminated skin lesions have higher relapse rate and shorter DFS suggesting further investigation on systemic therapies in such a group of patients.
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Affiliation(s)
- Octavio Servitje
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain.
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Zeidan A, Faltas B, Forde P, Subhawong A, Bello C, Bolaños-Meade J. Sequential occurrence of a splenic marginal zone lymphoma, extranodal MALT lymphoma, and Hodgkin lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 13:496-8. [PMID: 23747079 DOI: 10.1016/j.clml.2013.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 04/17/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Amer Zeidan
- Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
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20
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Gallo E, Pérez-Gala S, Navarro R, Fraga J, Adrados M, Arranz R, García-Diez A, Aragüés M. Coexistence of marginal zone cutaneous B-cell lymphoma and classic Hodgkin disease: does a biological relationship exist? Clin Exp Dermatol 2013; 38:383-5. [DOI: 10.1111/j.1365-2230.2012.04478.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Matsuo T, Ichimura K, Shinagawa K. Orbital MALT lymphoma, abdominal hodgkin lymphoma, and systemic diffuse large B-cell lymphoma develop sequentially in one patient. J Clin Exp Hematop 2012; 52:41-9. [PMID: 22706530 DOI: 10.3960/jslrt.52.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
In February 2002, a 42-year-old woman developed ocular adnexal extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), MALT lymphoma, in the bilateral orbits involving lacrimal glands. She underwent 30 Gy external beam irradiation to the orbital lesions on both sides. She was well until November 2008 when she developed abdominal lymphadenopathy and transabdominal excisional biopsy showed mixed cellularity classical Hodgkin lymphoma at stage II. She underwent standard combination chemotherapy. In July 2010, she developed systemic lymphadenopathy and was diagnosed with diffuse large B-cell lymphoma (DLBCL) by cervical lymph node biopsy. She underwent rituximab monotherapy and finally allogeneic hematopoietic stem cell transplantation in October 2010, but died of renal failure in February 2011. Amplification by polymerase chain reaction of the immunoglobulin heavy chain gene gave rise to dominant discrete fragments of the same size between the orbital lesion with MALT lymphoma in 2002 and the cervical lymph node lesion with DLBCL in 2010. The sequential development of MALT lymphoma, Hodgkin lymphoma, and DLBCL in the long-term course of this patient suggests the common origin of the neoplastic cells, changing their pathological faces in response to irradiation and combination chemotherapy.
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Affiliation(s)
- Toshihiko Matsuo
- Departments of Ophthalmology, Okayama University Medical School and Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama City, Japan.
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22
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Fujimoto M, Yuba Y, Huang CL, Kobashi Y, Koyanagi I, Sakashita H, Haga H. Coexistence of Epstein-Barr virus-associated lymphoproliferative disorder and marginal zone B-cell lymphoma of the thymus in a patient with rheumatoid arthritis treated with methotrexate. Histopathology 2012; 61:1230-2. [PMID: 22958131 DOI: 10.1111/j.1365-2559.2012.04338.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Oka K, Nagayama R, Yonekawa N, Nihei T, Sando N, Yatabe Y, Mori N. Concurrent Gastric MALT and Hodgkin Lymphoma. Int J Surg Pathol 2011; 20:201-4. [DOI: 10.1177/1066896911417242] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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.
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Affiliation(s)
- Kuniyuki Oka
- Mito Saiseikai General Hospital, Mito, Ibaraki, Japan
| | | | | | - Takeshi Nihei
- Mito Saiseikai General Hospital, Mito, Ibaraki, Japan
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24
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Demurtas A, Aliberti S, Bonello L, Di Celle PF, Cavaliere C, Barreca A, Novero D, Stacchini A. Usefulness of multiparametric flow cytometry in detecting composite lymphoma: study of 17 cases in a 12-year period. Am J Clin Pathol 2011; 135:541-55. [PMID: 21411776 DOI: 10.1309/ajcpqke25adcfzwn] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
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.
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25
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Oka K, Shinonaga M, Nagayama R, Kashimura H, Yonekawa N, Tatebe S, Kuraoka S, Yatabe Y, Mori N. Coexistence of primary pulmonary Hodgkin lymphoma and gastric MALT lymphoma associated with Epstein-Barr virus infection: A case report. Pathol Int 2010; 60:520-3. [DOI: 10.1111/j.1440-1827.2010.02554.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Raffegerst SH, Hoelzlwimmer G, Kunder S, Mysliwietz J, Quintanilla-Martinez L, Schendel DJ. Diverse hematological malignancies including hodgkin-like lymphomas develop in chimeric MHC class II transgenic mice. PLoS One 2009; 4:e8539. [PMID: 20046882 PMCID: PMC2796171 DOI: 10.1371/journal.pone.0008539] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 11/27/2009] [Indexed: 11/18/2022] Open
Abstract
A chimeric HLA-DR4-H2-E (DR4) homozygous transgenic mouse line spontaneously develops diverse hematological malignancies with high frequency (70%). The majority of malignancies were distributed equally between T and B cell neoplasms and included lymphoblastic T cell lymphoma (LTCL), lymphoblastic B cell lymphoma (LBCL), diffuse large B cell lymphoma (DLBCL), the histiocyte/T cell rich variant of DLBCL (DLBCL-HA/T cell rich DLBCL), splenic marginal zone lymphoma (SMZL), follicular B cell lymphoma (FBL) and plasmacytoma (PCT). Most of these neoplasms were highly similar to human diseases. Also, some non-lymphoid malignancies such as acute myeloid leukemia (AML) and histiocytic sarcoma were found. Interestingly, composite lymphomas, including Hodgkin-like lymphomas, were also detected that had CD30(+) Hodgkin/Reed-Sternberg (H/RS)-like cells, representing a tumor type not previously described in mice. Analysis of microdissected H/RS-like cells revealed their origin as germinal center B cells bearing somatic hypermutations and, in some instances, crippled mutations, as described for human Hodgkin lymphoma (HL). Transgene integration in an oncogene was excluded as an exclusive driving force of tumorigenesis and age-related lymphoma development suggests a multi-step process. Thus, this DR4 line is a useful model to investigate common molecular mechanisms that may contribute to important neoplastic diseases in man.
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Affiliation(s)
- Silke H Raffegerst
- Institute of Molecular Immunology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.
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27
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Bayerl MG, Hennessy J, Ehmann WC, Bagg A, Rosamilia L, Clarke LE. Multiple cutaneous monoclonal B-cell proliferations as harbingers of systemic angioimmunoblastic T-cell lymphoma. J Cutan Pathol 2009; 37:777-86. [DOI: 10.1111/j.1600-0560.2009.01408.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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28
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Stefanovic A, Morgensztern D, Fong T, Lossos IS. Pulmonary marginal zone lymphoma: a single centre experience and review of the SEER database. Leuk Lymphoma 2008; 49:1311-20. [PMID: 18604720 DOI: 10.1080/10428190802064933] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pulmonary marginal zone lymphoma is a rare disease arising from bronchial-associated lymphoid tissue (BALT). There is limited information on clinical presentation, natural history and treatment of this type of lymphoma. We conducted a retrospective review of patients with biopsy-proven BALT lymphoma treated at our institution and patients from the surveillance epidemiology and end results (SEER) database. Twenty-one patients (median age 57) with disease stage IE (n = 10) and IV (n = 11), were treated at our institution. Initial management included observation (n = 4), surgery (n = 5), combination chemotherapy (n = 7), single-agent rituximab (n = 3) and radioimmunotherapy (n = 2). Complete remission was observed in 10, partial remission in 3, stable disease in 7, and disease progression in 1 patient. With a median follow-up of 20 months, Kaplan-Meier estimates for progression-free and overall survival (OS) at 80 months were 90% and 95%, respectively. We identified 326 patients (59% females and 41% males; median age 68 [30 to 85) with BALT lymphoma in the SEER database. Fifty-five per cent had stage IE, 10% stage IIE, 3% stage IIIE, and 22% stage IV disease. After a median follow-up of 35 months, median OS was 112 months, and disease-specific median survival was not reached. At 90 months, disease-specific survival was 85% (CI 77-92) with no significant differences in outcome between patients presenting with different stages. Our single institution experience and review of the SEER database, confirm the indolent features and favourable outcome of this rare disease.
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Affiliation(s)
- Alexandra Stefanovic
- Department of Medicine, Division of Hematology-Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA
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29
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Wang HY, Karandikar N, Payne D, Maleki A, Schultz BA, Collins R, McKenna RW. A 3-way collision tumor of the upper respiratory tract: a composite of 2 immunophenotypically distinct mantle cell lymphomas and a plasmacytoma. Hum Pathol 2008; 39:781-7. [DOI: 10.1016/j.humpath.2007.08.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Revised: 08/15/2007] [Accepted: 08/31/2007] [Indexed: 10/22/2022]
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30
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ELMAHY H, HAWLEY I, BEARD J. Composite splenic marginal zone lymphoma and classic Hodgkin lymphoma – an unusual combination. Int J Lab Hematol 2007; 29:461-3. [DOI: 10.1111/j.1365-2257.2006.00859.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Harada S, Kalla H, Balasubramanian M, Brodsky I, Gladstone D, Hou JS. Classical Hodgkin lymphoma concurrently evolving in a patient with marginal zone B-cell lymphoma of the spleen. Ann Diagn Pathol 2007; 12:212-6. [PMID: 18486899 DOI: 10.1016/j.anndiagpath.2006.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Combination of the splenic marginal zone B-cell lymphoma (SMZL) and classical Hodgkin lymphoma (cHL) is extremely rare. We report a unique case with concurrent SMZL and cHL. The patient was a 63-year-old man who presented with fatigue and anemia, showing a splenomegaly and retroperitoneal lymphadenopathy. A splenectomy revealed monotonous marginal zone lymphocytic infiltrates and numerous large Reed-Sternberg-like cells. Flow cytometry revealed a kappa light-chain-restricted CD5 (-), CD23 (-) B-cell population. DNA polymerase chain reaction analysis confirmed the presence of clonal rearrangement of the immunoglobulin heavy-chain gene. Immunohistochemical studies revealed that the large atypical cells were CD30 (+), CD15 (weakly +), CD20 (-), CD45 (-), Pax5 (weakly +), BOB.1 (-), and Oct2 (-), indicating the coexistence of SMZL with cHL. After the chemotherapy, the patient achieved a clinical/radiologic remission, whereas cHL was detected in liver and bone marrow subsequently. The case indicates that both components of lymphoma can present concurrently as a composite form of lymphoma and both need to be treated adequately.
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Affiliation(s)
- Shuko Harada
- Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, PA 19102, USA
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32
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Saito M, Tanaka S, Mori A, Toyoshima N, Irie T, Morioka M. Primary gastric Hodgkin's lymphoma expressing a B-Cell profile including Oct-2 and Bob-1 proteins. Int J Hematol 2007; 85:421-5. [PMID: 17562619 DOI: 10.1532/ijh97.06094] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Classic Hodgkin's lymphoma (cHL) most often involves lymph nodes, and gastric involvement is rare. Hodgkin's and Reed-Sternberg (H-RS) cells in cHL are known to often lack expression of several B-lineage markers, such as CD20, CD79a, Oct-2, and Bob-1. We present an extremely rare case of mixed-cellularity cHL in the stomach in which expression of these B-cells was detected immunohistochemically. The patient was an 83-year-old Japanese woman who developed a sensation of abdominal fullness and appetite loss. Endoscopic and abdominal computed tomography examinations revealed a gastric ulcer lesion and swelling of para-aortic lymph nodes, respectively. A subtotal gastrectomy was performed, and the histopathologic diagnosis was established as a typical cHL compatible with stomach origin. The patient underwent postoperative chemotherapy of 3 cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and has since been in complete remission. Immunohistochemically, the H-RS cells in the cHL were positive not only for CD30 but also for CD20, CD79a, Oct-2, and Bob-1, whereas they were negative for CD3, CD15, CD45, EMA, and ALK1. Our patient may have had an intermediate cHL disease overlapping that of non-Hodgkin's peripheral B-cell lymphoma, possibly reflecting derivation from germinal-center B-cells.
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Affiliation(s)
- Makoto Saito
- Department of Internal Medicine, Aiiku Hospital, Sapporo, Japan.
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33
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Steinhoff M, Assaf C, Anagnostopoulos I, Geilen CC, Stein H, Hummel M. Three coexisting lymphomas in one patient: genetically related or only a coincidence? J Clin Pathol 2007; 59:1312-5. [PMID: 17142574 PMCID: PMC1860525 DOI: 10.1136/jcp.2005.030825] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The simultaneous manifestation of different lymphomas in the same patient or even in the same tissue, defined as composite lymphoma, is very rare. The exceptional case of a patient who, presented with simultaneous manifestation of three different lymphomas after 30 years of successful treatment of a nodal T cell lymphoma is reported here. The three lymphomas were: (1) primary cutaneous marginal zone B cell lymphoma (MZBL); (2) nodal Epstein-Barr virus (EBV)-associated classic Hodgkin's lymphoma (cHL) of the B cell type; and (3) peripheral T cell lymphoma coexisting in the skin and cervical lymph node. Immunohistochemical and molecular analyses showed different clonal origins of EBV-negative cutaneous MZBL and EBV-positive B cell cHL and, in addition, the presence of the same clonal T cell population in the skin and lymph node. The simultaneous occurrence of three different, clonally unrelated lymphomas in one patient at the same time has not been reported yet.
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MESH Headings
- Aged
- Epstein-Barr Virus Infections/complications
- Female
- Hodgkin Disease/genetics
- Hodgkin Disease/immunology
- Hodgkin Disease/pathology
- Hodgkin Disease/virology
- Humans
- Immunophenotyping
- Lymphoma/genetics
- Lymphoma/immunology
- Lymphoma/pathology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, T-Cell, Peripheral/genetics
- Lymphoma, T-Cell, Peripheral/immunology
- Lymphoma, T-Cell, Peripheral/pathology
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/immunology
- Neoplasms, Multiple Primary/pathology
- Skin Neoplasms/genetics
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
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Affiliation(s)
- M Steinhoff
- Department of Dermatology and Allergy, Charité-Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
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34
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Dickson BC, Serra S, Chetty R. Primary gastrointestinal tract lymphoma: diagnosis and management of common neoplasms. Expert Rev Anticancer Ther 2007; 6:1609-28. [PMID: 17134365 DOI: 10.1586/14737140.6.11.1609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Primary gastrointestinal lymphoma represents the most common location of extranodal lymphoma. With the bulk of disease manifesting within the gastrointestinal tract and contiguous lymph nodes, many of the lymphomas occurring in the peripheral lymph nodes can also present with primary gastrointestinal tract involvement. Molecular biology has recently enabled significant progress in the diagnosis and management of primary gastrointestinal lymphoma. Herein, we will discuss the major lymphomas affecting the bowel and highlight their key morphological, immunophenotypical and molecular diagnostic attributes. Similarly, in keeping with recent therapeutic advances, we will briefly discuss some important treatment considerations. Thus, this review is intended to offer clinicians and pathologists an overview of primary gastrointestinal lymphomas.
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Affiliation(s)
- Brendan C Dickson
- University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Department of Pathology, 200 Elizabeth Street, 11th Floor, Residents and Fellows Room, Toronto, Ontario, Canada.
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35
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Huang Q, Wilczynski SP, Chang KL, Weiss LM. Composite recurrent hodgkin lymphoma and diffuse large B-cell lymphoma: one clone, two faces. Am J Clin Pathol 2006. [PMID: 16891197 DOI: 10.1309/ddglwrv3kr9164g7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We describe a composite lymphoma with recurrent Hodgkin lymphoma and diffuse large B-cell lymphoma components manifesting as a single, perforated small intestinal tumor in a 56-year-old man with a history of classical Hodgkin lymphoma and recent relapse in the bone marrow. The resected mass had 2 morphologically and immunophenotypically distinct components; 1 showed a pleomorphic cellular infiltrate with fibrosis and contained numerous, large Hodgkin/Reed-Sternberg-like cells and variants. The tumor cells were CD30+ and focally positive for CD15 but CD20-, CD79a-, and PAX-5-. In situ hybridization for Epstein-Barr virus (EBV) was strongly positive in the large pleomorphic tumor cells. The adjacent component displayed sheets of relatively uniform, large lymphoid cells with typical morphologic features of diffuse large cell lymphoma. The tumor cells showed uniform expression of tested B-cell antigens, absence of CD30 or CD15, and complete absence of EBV-encoded RNA. Separate molecular studies with immunoglobulin heavy and k light chain gene rearrangements clearly demonstrated an identical rearrangement pattern, indicating derivation from the same clone, which was confirmed by direct DNA sequencing analysis. Such distinctly different morphology, immunophenotype, and EBV status in different components within a clonally related single tumor mass is striking.
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Abstract
Hodgkin lymphoma (HL) is a distinctive lymphoma subtype that accounts for approximately 30% of all lymphomas in the Western world and approximately 5% in Japan. HL is characterized by the giant multinucleated tumor cells called Hodgkin/Reed-Sternberg (H/RS) cells, but the cellular origin had long been unknown. Recent investigations have clarified that H/RS cells have a clonally rearranged immunoglobulin gene in most cases, but it still seems appropriate to differentiate HL from other B-cell neoplasms, because the transforming event rather than its cellular origin is more likely to influence the nature of H/RS cells. Many questions remain to be answered for comprehensive understanding of the pathogenesis of HL. The presence of H/RS cells alone is probably not enough for disease onset, but the immune reaction against these cells appears to be inevitable for generation of HL. Most HL patients are cured with current treatment strategies, but some of them have refractory or recurrent disease, and intensified treatment occasionally induces therapy-related secondary malignancies. Because the growth and survival of H/RS cells are supported by various external stimuli and constitutive intracellular signals, management of HL is expected to be one of the best applications of molecule-targeted therapy.
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MESH Headings
- B-Lymphocytes/pathology
- Cell Differentiation/genetics
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/pathology
- Disease-Free Survival
- Gene Rearrangement, B-Lymphocyte/genetics
- Hodgkin Disease/epidemiology
- Hodgkin Disease/etiology
- Hodgkin Disease/genetics
- Hodgkin Disease/pathology
- Hodgkin Disease/therapy
- Humans
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/etiology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Recurrence
- Reed-Sternberg Cells/pathology
- Signal Transduction/genetics
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Affiliation(s)
- Momoko Nishikori
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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