Transformation of small B-cell lymphoma into large cell CD30⁺, CD4⁺, Epstein-Barr virus-negative lymphoma

Arch Pathol Lab Med. 2014 Aug;138(8):1101-5. doi: 10.5858/arpa.2013-0089-CR.

Abstract

We report here 2 separate cases in which patients with known low-grade B-cell lymphomas presented with transformed lesions that were CD30⁺, CD4⁺, Epstein-Barr virus negative, and negative or focally weak for a wide range of B-cell, T-cell, and histiocytic/dendritic cell markers. In each case the transformed lymphoma possessed an identical pattern of immunoglobulin heavy chain and/or BCL2 rearrangement to the corresponding original low-grade B-cell lymphoma, confirming their identity as transformed B-cell lymphoma. A review of the relevant literature reveals that, to our knowledge, no transformed B-cell lymphomas with this immunophenotype have been previously reported, which creates the opportunity for potential errors of diagnosis. These cases highlight the importance of correlation with the patient's history and with molecular genetic results in rendering an accurate diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers / metabolism
  • Biopsy
  • CD4 Antigens / metabolism
  • Cell Transformation, Neoplastic*
  • Diagnosis, Differential
  • Female
  • Gene Rearrangement, B-Lymphocyte*
  • Gene Rearrangement, B-Lymphocyte, Heavy Chain
  • Humans
  • Ki-1 Antigen / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Lymphoma, Follicular / diagnosis
  • Lymphoma, Follicular / genetics
  • Lymphoma, Follicular / metabolism
  • Lymphoma, Follicular / pathology
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / genetics
  • Lymphoma, Large B-Cell, Diffuse / metabolism
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large-Cell, Anaplastic / diagnosis
  • Lymphoma, Large-Cell, Anaplastic / genetics
  • Lymphoma, Large-Cell, Anaplastic / metabolism
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Proteins / metabolism
  • Proto-Oncogene Proteins c-bcl-2 / genetics
  • Proto-Oncogene Proteins c-bcl-2 / metabolism

Substances

  • Biomarkers
  • CD4 Antigens
  • Ki-1 Antigen
  • Neoplasm Proteins
  • Proto-Oncogene Proteins c-bcl-2