Collision Anaplastic Large Cell Lymphoma (T-Cell/Histiocyte-Rich) and Diffuse Large B Cell Lymphoma: A Pathologic and Clinical Evaluation
- 1 Division of Hematopathology, Department of Pathology, The Ohio State University Medical Center, Columbus, USA
- 2 Division of Hematology, The Department of Medicine, The Ohio State University Medical Center, Columbus, USA.
- 3 Division of Hematology, The Department of Medicine, The Ohio State University Medical Center, Columbus, USA
- 4 Division of Hematopathology, Department of Pathology, The Ohio State University Medical Center, Columbus, USA
- 5 Division of Hematology, The Department of Medicine, The Ohio State University Medical Center, Columbus, USA.
- 6 Division of Hematopathology, Department of Pathology, The Ohio State University Medical Center, Columbus, USA
Abstract
A collision tumor of T and B-cell lymphomas occur rarely. In this article we report a collision tumor of anaplastic large cell lymphoma and diffuse large B cell lymphoma in a 46 year old female. The tumor showed predominantly neoplastic anaplastic large cell lymphoma (ALCL) component expressing CD30 and ALK with smaller areas of CD20+ diffuse large B cell lymphoma component. Polymerase chain reaction for T-cell receptor beta and IgH (VDJ) gene rearrangements detected a clonal T cell and a clonal B cell population. The patient developed CSF involvement approximately 3 months after treatment. CSF analysis at this time showed only monoclonal T cells, probably due to clearing of the B cell component by the chemotherapy. To the best of our knowledge this is the first case report of a composite tumor of ALCL (lymphohistiocytic variant) and DLBCL. This case raises issues related to the classification of these composite lymphomas and the treatment on initial presentation and during relapse.
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