Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: evidence for transdifferentiation of the follicular lymphoma clone

Abstract

Rare cases of histiocytic and dendritic cell (H/DC) neoplasms have been reported in patients with follicular lymphoma (FL), but the biologic relationship between the 2 neoplasms is unknown. We studied 8 patients with both FL and H/DC neoplasms using immunohistochemistry, fluorescence in situ hybridization (FISH) for t(14;18), and polymerase chain reaction (

A rare case of follicular lymphoma with transformation to diffuse large B-cell lymphoma and transdifferentiation to histiocytic sarcoma

“…[8] When HS occurs in the context of another hematologic malignancy, the two entities are often clonally related. [9,12] FISH demonstrated the presence of t(14;18)(q32;q21) in our patient's FL, DLBCL and HS. Previous publication by Andrew L. Feldman, et al evaluated 8 patients with both FL and H/DC neoplasms using immunohistochemistry, FISH testing for t (14;18), and polymerase chain reaction (PCR) sequencing of BCL2 and IGH rearrangements.…”

“…Published by Sciedu Press in the literature by Feldman et al [9] This is a complex diagnosis and the case was sent out for expert consultation to the Mayo Clinic who agreed with the above interpretation.…”

“…These studies have shown evidence of cross-lineage transdifferentiation of B-cells to histiocytic and dendritic cell sarcomas. [9][10][11] Interestingly, sporadic H/DC sarcomas have also shown evidence of clonal immunoglobulin receptor gene rearrangements. [3] 2.…”

Molecular genetic data favoring a sequential clonal transformation of a large B cell lymphoma into an anaplastic large T cell lymphoma, ALK-negative

“…They include transformation of lymphoid neoplasms into Langerhans cell neoplasms and histocytic sarcomas and chronic myeloid leukemia into T cell lymphoblastic lymphoma [20][21][22][23][24][25].…”

Lymphoma classification and the tools of our trade: an introduction to the 2012 USCAP Long Course

“…Monoclonality is not necessarily equivalent to the diagnosis of a malignant lymphoma and lack of a demonstrable clone is not equivalent to assurance that a B-or T-cell proliferation is benign. If a clonal population is present and detected, the molecular studies may still be misleading by suggesting the 'wrong' lineage (eg, IGH@ rearrangements in some histiocytic/dendritic neoplasms [28][29][30][31] ) or they may lead to a diagnostic error by identifying a clone that is less important than something else present (eg, finding a restricted T-cell population without a demonstrable immunoglobulin gene rearrangement in a B-cell neoplasm).…”