Title | A distinctive composite lymphoma consisting of clonally related mantle cell lymphoma and follicle center cell lymphoma. |
Publication Type | Journal Article |
Year of Publication | 1999 |
Authors | Tsang P, Pan L, Cesarman E, Tepler J, Knowles DM |
Journal | Hum Pathol |
Volume | 30 |
Issue | 8 |
Pagination | 988-92 |
Date Published | 1999 Aug |
ISSN | 0046-8177 |
Keywords | Aged, Antigens, CD, Blotting, Southern, Female, Humans, Immunophenotyping, Lymphoma, Follicular, Lymphoma, Non-Hodgkin, Proto-Oncogene Proteins c-bcl-2, Translocation, Genetic |
Abstract | Although follicle center cell lymphoma and mantle cell lymphoma are both B cell non-Hodgkin's lymphomas (NHL), they are regarded as separate entities with distinct clinical, morphological, immunophenotypic and molecular characteristics. To our knowledge, the coexistence of these 2 lymphomas in the same patient has never been reported. We describe a 70-year-old woman with a long-standing history of follicle center cell lymphoma, cytological grade I, who subsequently developed a composite lymphoma consisting of well-demarcated foci of persistent follicle center cell lymphoma surrounded by mantle cell lymphoma. This morphological interpretation was supported by the presence of both bcl-1 and bcl-2 gene rearrangements, which are molecular genetic hallmarks of mantle cell lymphoma and follicle center cell lymphoma, respectively. Polymerase chain reaction (PCR) analysis for rearranged immunoglobulin heavy chain (IgH) genes showed a dominant band identical in size in microdissected tumor cells of the follicle center cell and mantle cell lymphomas. Cloning and sequence analysis of the PCR products revealed a common clone-specific IgH gene rearrangement in these 2 lymphomas. These findings suggest that this composite lymphoma represents the unusual evolution of a malignant B-cell clone that resulted in the development of 2 morphologically distinct but clonally related B-cell NHLs. These findings also show the importance of integrating morphological, immunophenotypic, and molecular data to enhance our understanding of the complex pathogenic interrelationships in lymphomagenesis. |
DOI | 10.1016/s0046-8177(99)90256-3 |
Alternate Journal | Hum Pathol |
PubMed ID | 10452515 |
Related Faculty:
Ethel Cesarman, M.D., Ph.D.