Cytogenetic and molecular characterization of a patient with simultaneous B‐cell chronic lymphocytic leukemia and peripheral T‐cell lymphoma

Martin-Subero, José Ignacio; Siebert, Reiner; Harder, Lana; Gesk, Stefan; Schwindt, Peter D. D.; Bräuninger, Andreas; Willenbrock, Klaus; Steinemann, Doris; Tiemann, Markus; Calasanz, Marı́a José; Grote, W.; Ludwig, Wolf‐Dieter; Hansmann, Martin‐Leo; Schlegelberger, Brigitte

doi:10.1002/ajh.1190

Cited by 14 publications

(15 citation statements)

References 14 publications

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“…From the clonality study examining two representative patients we have shown that these tumors may arise either from a single clone or from multiple clones of T cells. Our findings that different types of lymphoid neoplasms can occur in a patient, simultaneously or subsequently, correspond to previous reports on EBV‐associated T‐cell and B‐cell neoplasms 2,21,52 . For the pathogenic mechanism of the EBV‐associated peripheral T‐cell proliferative disease/lymphoma, we postulate that the EBV that is dormant in the latently EBV‐infected B cells may infect many subsets of T cells.…”

Section: Discussionsupporting

confidence: 89%

Hepatic cytotoxic T‐cell infiltrates in patients with peripheral T‐cell proliferative diseases/lymphomas: Clinicopathological and molecular analysis

Mitarnun

Saechan

Suwiwat

et al. 2004

Pathology International

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Seventy patients with various types of peripheral T-cell proliferative disease/lymphoma who manifested with prolonged fever, weight loss, anemia, lymphadenopathy, hepatosplenomegaly and elevated serum levels of alkaline phosphatase and/or lactate dehydrogenase were evaluated. Histopathological examination of the livers revealed T-cell infiltration into the hepatic sinusoids and portal tracts. The morphology of the infiltrated T cells varied from mature small lymphocytes to malignant lymphoid cells. The liver pathology was classified into four groups on the basis of cellular atypia. Group A and group B showed mature lymphoid cell infiltration; however, only group B had multiple large areas of hepatocellular necrosis. Group C showed atypical lymphoid cell infiltration and in group D malignant lymphoid cell infiltrates were demonstrated. The majority of the antigenic phenotypes of these T-cell infiltrates were CD3+, CD4-, CD8+, CD20-, CD45RO+, CD56-, CD57-, TIA-1+ and betaF1-. Epstein-Barr virus RNA in the nuclei of the infiltrated T cells was recorded in 38.6% of the patients and was more common in groups C and D. Patients in groups B, C and D had a very poor prognosis, median survival was only 1 month, whereas median survival in group A patients was 36 months. Chemotherapy was not effective in improving survival. Monoclonal band/s of T-cell receptors (TCR) beta and/or gamma gene rearrangements were detected in 88.6% of patients, and DNA-sequence analysis showed high identity to the human TCR germline gene.

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Section: Discussionsupporting

confidence: 89%

Hepatic cytotoxic T‐cell infiltrates in patients with peripheral T‐cell proliferative diseases/lymphomas: Clinicopathological and molecular analysis

Mitarnun

Saechan

Suwiwat

et al. 2004

Pathology International

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“…In contrast to most of the PTCLs previously encountered, 2 of our 3 patients had ALK + ALCL, both occurring in women. 19 The clinical features of our 3 cases and of other cases of PTCL in CLL patients 6,18,[20][21][22][23][24][25][26][27][28][29][30] are summarized in Tables 1 and 3. One additional case of ALK + ALCL arising in a patient with CLL/SLL has been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…PTCLs in CLL/SLL Patients: Review of Literature study had limited-stage disease and responded well to therapy, in contrast to most other PTCL. A previously described case of composite SLL and CD4 + PTCL was shown to be genetically distinct on the basis of the identification of trisomy 12 limited to the SLL cells and trisomy 8 limited to the CD4 + T cells 25. Another consideration is whether the CLL and the PTCL might be clonally related, as is the case with many of the diffuse large B-cell lymphomas arising in CLL patients,12,13,15 although this seems less likely for PTCLs.…”

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confidence: 98%

Peripheral T-cell Lymphomas With Cytotoxic Phenotype in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Boyer

Lindeman

Harris

et al. 2014

American Journal of Surgical Pathology

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Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is relatively common, and patients occasionally develop other neoplasms; however, patients who develop other types of lymphomas are rare. We encountered 3 patients with CLL/SLL (one 59-y-old man and 2 women aged 56 and 66 y) who developed T-cell lymphomas. Both women developed ALK anaplastic large cell lymphomas (ALCLs), whereas the man developed CD8 peripheral T-cell lymphoma, not otherwise specified. All 3 T-cell lymphomas expressed granzyme B and perforin, indicating a cytotoxic immunophenotype. In 1 case, the first presentation was a lymph nodal composite lymphoma. In the other 2 cases, the T-cell lymphomas arose <1 year after the diagnosis of CLL/SLL and were identified in a lymph node in one case and in the spleen in the other. The patient with a composite lymphoma (SLL/ALK ALCL) was treated and was free of disease at last follow-up, whereas the other 2 patients succumbed to their disease, 1 month and 7 months after the diagnosis of T-cell lymphoma. Peripheral T-cell lymphomas rarely occur in CLL/SLL patients. On the basis of our small series, those with a cytotoxic phenotype appear to be more common in this setting. The occurrence of ALK ALCL in 2 older patients was especially surprising and suggested that CLL/SLL may have played a role in the development of ALCL.

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“…2 A review of the published cases shows 13 cases of synchronous or metachronous occurrence of B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) and peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS) in the same biopsy specimen (Table 1). [3][4][5][6][7][8][9] Immune dysregulation as a mechanism underlying the simultaneous occurrence of 2 lymphoid malignancies has been proposed, and the chronic stimulation of T-cells by the neoplastic B-SLL clone is a well-documented phenomenon in the literature. 8 HLH is a syndrome of pathological immune activation characterized by severe inflammation and cytokinemia.…”

Section: Introductionmentioning

confidence: 99%

Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis

Alomari

Hui

2012

Int J Surg Pathol

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We report a case of a 68-year-old female patient who developed hemophagocytic lymphohistiocytosis (HLH) secondary to peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS) that developed in the setting of treatment-resistant B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL). The patient's B-cell lymphoma had a good initial response to chemotherapy for 4 years, after which it became less responsive and was thought to have undergone transition to a higher-grade lymphoma. Different regimens of chemoradiotherapy were then tried with modest response until the patient presented 3 years later with signs and symptoms of HLH. The patient died 1 month later, and an autopsy was performed. Significant para-aortic lymphadenopathy and splenomegaly were found. Microscopic, immunohistochemical and molecular evaluations confirmed the presence of composite B-cell and T-cell lymphoma in the para-aortic enlarged lymph nodes. Bone marrow examination showed hemophagocytosis, and the liver demonstrated infiltration by activated macrophages with hepatocellular necrosis. This report highlights the importance of searching for a possible underlying T-cell lymphoma in light of HLH. Different theories have been proposed to explain the rare occurrence of concurrent B- and T-cell lymphomas, but the development of HLH in this patient highlights the importance of immune dysregulation as a proposed mechanism to explain some cases of composite lymphomas. A review of the literature and discussion of the relative merits of these hypotheses are presented in the context of this case.

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Cytogenetic and molecular characterization of a patient with simultaneous B‐cell chronic lymphocytic leukemia and peripheral T‐cell lymphoma

Cited by 14 publications

References 14 publications

Hepatic cytotoxic T‐cell infiltrates in patients with peripheral T‐cell proliferative diseases/lymphomas: Clinicopathological and molecular analysis

Hepatic cytotoxic T‐cell infiltrates in patients with peripheral T‐cell proliferative diseases/lymphomas: Clinicopathological and molecular analysis

Peripheral T-cell Lymphomas With Cytotoxic Phenotype in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis

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