High-Grade B-Cell Neoplasm with Surface Light Chain Restriction and Tdt Coexpression Evolved in a MYC-Rearranged Diffuse Large B-Cell Lymphoma: A Dilemma in Classification
Joint Authors
Soliman, Dina Sameh
Al-Sabbagh, Ahmad
Ibrahim, Feryal
Yassin, Mohamed
Taha, Ruba Y.
Nawaz, Zafar
Elkourashy, Sarah
Haider, Abdulrazzaq
Akiki, Susanna
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-08-13
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
According to World Health Organization (WHO) classification (2008), B-cell neoplasms are classified into precursor B-cell or a mature B-cell phenotype and this classification was also kept in the latest WHO revision (2016).
We are reporting a male patient in his fifties, with tonsillar swelling diagnosed as diffuse large B-cell lymphoma (DLBCL), germinal center.
He received 6 cycles of RCHOP and showed complete metabolic response.
Two months later, he presented with severe CNS symptoms.
Flow cytometry on bone marrow (BM) showed infiltration by CD10-positive Kappa-restricted B-cells with loss of CD20 and CD19, and downregulation of CD79b.
Moreover, the malignant population showed Tdt expression.
BM Cytogenetics revealed t(8;14)(q24;q32) within a complex karyotype.
Retrospectively, MYC and Tdt immunostains performed on original diagnostic tissue and came negative for Tdt and positive for MYC.
It has been rarely reported that mature B-cell neoplasms present with features of immaturity; however the significance of Tdt acquisition during disease course was not addressed before.
What is unique in this case is that the emerging disease has acquired an immaturity marker while retaining some features of the original mature clone.
No definitive WHO category would adopt high-grade neoplasms that exhibit significant overlapping features between mature and immature phenotypes.
American Psychological Association (APA)
Soliman, Dina Sameh& Al-Sabbagh, Ahmad& Ibrahim, Feryal& Taha, Ruba Y.& Nawaz, Zafar& Elkourashy, Sarah…[et al.]. 2017. High-Grade B-Cell Neoplasm with Surface Light Chain Restriction and Tdt Coexpression Evolved in a MYC-Rearranged Diffuse Large B-Cell Lymphoma: A Dilemma in Classification. Case Reports in Hematology،Vol. 2017, no. 2017, pp.1-9.
https://search.emarefa.net/detail/BIM-1145934
Modern Language Association (MLA)
Soliman, Dina Sameh…[et al.]. High-Grade B-Cell Neoplasm with Surface Light Chain Restriction and Tdt Coexpression Evolved in a MYC-Rearranged Diffuse Large B-Cell Lymphoma: A Dilemma in Classification. Case Reports in Hematology No. 2017 (2017), pp.1-9.
https://search.emarefa.net/detail/BIM-1145934
American Medical Association (AMA)
Soliman, Dina Sameh& Al-Sabbagh, Ahmad& Ibrahim, Feryal& Taha, Ruba Y.& Nawaz, Zafar& Elkourashy, Sarah…[et al.]. High-Grade B-Cell Neoplasm with Surface Light Chain Restriction and Tdt Coexpression Evolved in a MYC-Rearranged Diffuse Large B-Cell Lymphoma: A Dilemma in Classification. Case Reports in Hematology. 2017. Vol. 2017, no. 2017, pp.1-9.
https://search.emarefa.net/detail/BIM-1145934
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145934