A Case of B-cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-cell Lymphoma and Burkitt Lymphoma in a Korean Child.
10.3343/alm.2012.32.2.162
- Author:
Jeong Yeal AHN
1
;
Yiel Hea SEO
;
Pil Whan PARK
;
Kyung Hee KIM
;
Mi Jung PARK
;
Ji Hoon JEONG
;
Soon Ho PARK
;
Young Hee SONG
Author Information
1. Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea. jyahn@gilhospital.com
- Publication Type:Case Reports
- Keywords:
Diffuse large B-cell lymphoma;
Burkitt lymphoma;
Gray zone lymphoma
- MeSH:
Antineoplastic Agents/therapeutic use;
Bone Marrow Cells/pathology;
Child, Preschool;
Chromosomes, Human, Pair 14;
Chromosomes, Human, Pair 8;
Cyclophosphamide/therapeutic use;
Doxorubicin/therapeutic use;
Drug Therapy, Combination;
Femur Neck/pathology;
Humans;
Immunohistochemistry;
Immunophenotyping;
In Situ Hybridization, Fluorescence;
Karyotyping;
Lymphoma, B-Cell/*diagnosis/drug therapy;
Male;
Methotrexate/therapeutic use;
Oncogene Proteins, Fusion/genetics;
Prednisolone/therapeutic use;
Republic of Korea;
Translocation, Genetic;
Treatment Outcome;
Vincristine/therapeutic use
- From:Annals of Laboratory Medicine
2012;32(2):162-166
- CountryRepublic of Korea
- Language:English
-
Abstract:
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL) (intermediate DLBCL/BL), is a heterogeneous group with some features resembling DLBCL and others resembling BL. Here, we report a case of intermediate DLBCL/BL in a Korean child. A 2-yr-old male was admitted for evaluation and management of left hip pain. Immunohistochemistry of a biopsy of the femur neck revealed tumor cells positive for CD20, CD10, BCL2, BCL6, and Ki67. A bone marrow (BM) aspirate smear revealed that 49.3% of all nucleated cells were abnormal lymphoid cells, composed of large- and medium-sized cells. Immunophenotyping of the neoplastic cells revealed positivity for CD19, CD10, CD20, and sIg lambda and negativity for CD34, Tdt, and myeloperoxidase (MPO). Cytogenetic and FISH analyses showed a complex karyotype, including t(8;14)(q24.1;q32) and IGH-MYC fusion. Intensive chemotherapy was initiated, including prednisone, vincristine, L-asparaginase, daunorubicin, and central nervous system prophylaxis with intrathecal methotrexate (MTX) and cytarabine. One month after the initial diagnosis, BM examination revealed the persistent of abnormal lymphoid cells; cerebrospinal fluid cytology, including cytospin, showed atypical lymphoid cells. The patient was treated again with cyclophosphamide, vincristine, prednisone, adriamycin, MTX, and intrathecal MTX and cytarabine. The patient died of sepsis 5 months after the second round of chemotherapy.
