Diapositiva 1

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
CD20
Cyclin D1
CD23
Ki67
CD20
Cyclin D1
CD23
Ki67
FISH studies
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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 total
DNA CD23+
DNA CD23-
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
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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
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