Concurrent classical Hodgkin lymphoma and plasmablastic lymphoma in a patient with chronic lymphocytic leukemia/small lymphocytic lymphoma treated with fludarabine: a dimorphic presentation of iatrogenic immunodeficiency-associated lymphoproliferative disorder with evidence suggestive of multiclonal transformability of B cells by Epstein-Barr virus

被引：21
作者：
Foo, Wen-Chi [1 ]
Huang, Qin [2 ]
Sebastian, Siby [1 ]
Hutchinson, Charles B. [1 ]
Burchette, Jim [1 ]
Wang, Endi [1 ]
机构：
[1] Duke Univ, Med Ctr, Dept Pathol, Durham, NC 27710 USA
[2] City Hope Natl Med Ctr, Dept Pathol, Duarte, CA 91010 USA
来源：
HUMAN PATHOLOGY | 2010年 / 41卷 / 12期
关键词：
Chronic lymphocytic leukemia/small lymphocytic lymphoma; Richter's syndrome; Epstein-Barr virus; Fludarabine; Classical Hodgkin lymphoma; Plasmablastic lymphoma; Immunodeficiency; RICHTERS TRANSFORMATION; DISEASE VARIANT;
D O I：
10.1016/j.humpath.2010.04.019
中图分类号：
R36 [病理学];
学科分类号：
100104 ;
摘要：
A small fraction of patients with chronic lymphocytic leukemia/small lymphocytic lymphoma develop Epstein-Barr virus-positive B-cell lymphoproliferative disorders These Epstein-Barr virus-Been lymphoproliferative disorders are thought to be related to immune suppression Induced by fludarabine/other chemotherapeutic regimens As in other immunodeficiency-associated lymphoproliferative disorders, these disorders demonstrate a heterogeneous histological spectrum that ranges from polymorphic to monomorphic to classical Hodgkin lymphoma-like lesions We report a case of concurrent classical Hodgkin lymphoma and plasmablastic lymphoma in a patient with chronic lymphocytic leukemia/small lymphocytic lymphoma treated with fludarabine Both classical Hodgkin lymphoma and plasmablastic lymphoma were positive for Epstein-Barr virus-encoded RNA, whereas classical Hodgkin lymphoma was also positive for Epstein-Barr virus- latent membrane protein I, suggesting a different viral latency Immunoglobulin gene rearrangement studies demonstrated distinct clones in the plasmablastic lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma These findings suggest biclonal secondary lymphomas associated with iatrogenic immunodeficiency Epstein-Barr virus-B-cell lymphoproliferative disorders in the setting of chronic lymphocytic leukemia/small lymphocytic lymphoma, in particular those arising after chemotherapy, should be separated from true Richter's transformation, and be categorized as (iatrogenic) immunodeficiency-associated lymphoproliferative disorder (C) 2010 Elsevier Inc All rights reserved
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收藏
页码：1802 / 1808
页数：7
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