Splenic Marginal Zone Lymphoma with Prominent Myelofibrosis Mimicking Triple-Negative Primary Myelofibrosis

Simultaneous blastic plasmacytoid dendritic cell neoplasm and myelofibrosis: A case report

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an extremely rare and aggressive tumor with an unknown pathogenesis. Myelofibrosis (MF) is a type of myeloproliferative neoplasm. MF can be secondary to several hematological malignancies, including chronic myeloid leukemia, myelodysplastic syndrome and hairy cell leukemia. In the present report, a rare case of BPDCN secondary to MF is described. A 70-year-old male patient developed a large purplish-red rash with recurrent symptoms. BPDCN was confirmed by immunohistochemistry of a biopsy specimen and flow cytometry of bone marrow cells. Bone marrow histopathology revealed MF. Next-generation sequencing of peripheral blood revealed mutations in the Tet methylcytosine dioxygenase 2 and NRAS proto-oncogene GTPase genes. The patient underwent one cycle of chemoimmunotherapy, but the condition progressed, an infection developed and the patient eventually died. The present case suggests that BPDCN can occur in conjunction with MF and that the prognosis of such patients is poor. Pathological examination and genetic testing aided in the diagnosis and treatment. This case emphasizes the need to raise awareness of BPDCN among clinicians and to be alert to the potential for fatal infection in patients with BPDCN combined with MF following myelosuppression triggered during chemotherapy.

Brucellosis complicated by myelofibrosis: report of five cases and review of literature

Myelofibrosis is a myeloproliferative tumor, that can be secondary to malignant hematologic or inflammatory diseases, such as chronic myeloid leukemia, polycythemia vera, primary thrombocythemia, multiple myeloma, disseminated tuberculosis, or vasculitis. However, few cases of brucellosis-associated myelofibrosis have been reported. Moreover, due to the rarity of this phenomenon, it is often overlooked by clinicians, resulting in misdiagnosis and mismanagement. Thus, brucellosis should be considered as a possible cause of myelofibrosis. In the present study, we report five cases of brucellosis, of which three had myelofibrosis. In addition, to further determine the potential link between brucellosis and myelofibrosis, we retrospectively analyzed the levels of various cytokines by collecting the clinicopathologic data of patients and using immunohistochemical staining. We found that brucellosis patients with myelofibrosis had elevated levels of cytokines such as interferon (IFN)-γ, interleukin (IL)-1β, basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), suggesting that the regulation of cytokines may play a central role in the development of myelofibrosis in patients with brucellosis.

Simultaneous Follicular Lymphoma and Myelofibrosis: Report of a Case with Review of the Literature

Background

Myelofibrosis (MF) is often associated with chronic myeloid leukemia, myelodysplastic syndrome and primary myeloproliferative neoplasms (MPN), but few number cases of malignant lymphoma with myelofibrosis was reported, and a few cases about follicular lymphoma with MF were found. Here we described a case of follicular lymphoma (FL) complicated by myelofibrosis.

Case Presentation

A 43-year-old man was diagnosed with follicular lymphoma (FL) complicated by MF, besides, the lymphoma staging of this patient was AnnArbor IV B. The cytokines of plated-derived growth factor (PDGF), basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), interleukin-2 (IL-2), and transforming growth factor-β (TGF-β) were positive, while JAK2V617F, MPL, and CALR mutations were negative. After first course of chemotherapy, the peripheral blood and MF improved. The systemic superficial lymph nodes and spleen were significantly narrowed after the third cycle of chemotherapy.

Conclusion

The production of various cytokines, such as b-FGF, TNF-α, TGF-β, PDGF, IL-1β, IL-2, IL-6, IL-10, may contribute to the development of MF.