CLUB DE LINFOMAS

Santander, 17-19 de Abril 2013

Mar Garcia

Hospital del Mar

CLINICAL DATA

• 61 yo male, with axillary lymph node

• Asymptomatic

• Marked leukocytosis (48.290 lymphs) and

cervical lymph nodes (2)

– PB Immunophenotype: 32% B-lymphocytes, 30% of

which with light chain restriction and CLL phenotype

CD20

CD5

Cyclin D1

Ki67

CD20

CD23

Cyclin D1

Ki67

CD20

CD23

FISH studies

• t(11;14)(q13:q32): translocated

• ATM (11q22.3-23.1): no loss of ATM

• CEP12: no trisomy

• Rb (13q14): no deletion of 13q14 region

• TP53: not done (no IHQ overexpression)

CCND1 (11q13)

IGH (14q32)

IgH Rearrangements

DNA CD23+

DNA CD23-

DNA total

FINAL DIAGNOSIS

MANTLE CELL LYMPHOMA, blastoid

variant, AND SLL/CLL

DISCUSSION

• Composite lymphomas: occurrence of unrelated,

morphologically and genetically distinct lymphomas

in the same mass

• Rare

• B+B, T+T, B+T

– CHL and non- hodgkin lymphoma

– Both components are genetically identical

• True composite lymphomas are more unusual

• Previous chemotherapeutic agents or immunological

defects as an explanation

REFERENCES

• Carbone A et al. Am J Hematol 2011 86(12):E66-70

• Steinhoff M et al. J Clin Pathol 2006;59:1312-1315

• Zettl A et al. Histopathology 2005;46:217-28

• Steinhoff M et al. J Clin Pathol 2004;57:329-331

• Küppers R et al. Molecular Medicine 2001 7(5):285-292

• Marafioti T et al. J Clin Oncol 1999;17:3804-9

• Brauninger A et al. N Engl J Med 1999;340:1239-47

• Delabie J et al. Am J Surg Pathol 1996;20(3):355-62

• Jaffe ES et al. Sem Diagn Pathol 1992;9:297-303

94972@parcdesalutmar.cat