Secondary follicular lymphoma of the bone, transformed into large cell lymphoma, in a patient with chronic lymphocytic leukaemia: an uncommon manifestation of Richter's syndrome

• Published in: European journal of haematology Vol. 72; no. 3; pp. 217 - 221
• Main Authors: Hensel, Manfred, Buss, Eike C., Tiemann, Markus, Parwaresch, Reza, Libicher, Martin, Fruehauf, Stefan, Ho, Anthony D.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.03.2004
• Subjects: Aged; Bone Neoplasms - etiology; Bone Neoplasms - pathology; CCC; Cell Transformation, Neoplastic; Female; follicular; Humans; Immunohistochemistry; Immunophenotyping; large cell lymphoma; Leukemia, Lymphocytic, Chronic, B-Cell - complications; lymphoma; Lymphoma, Follicular - etiology; Lymphoma, Follicular - pathology; Lymphoma, Large B-Cell, Diffuse - etiology; Lymphoma, Large B-Cell, Diffuse - pathology; Neoplasms, Second Primary - pathology; Radiography; Richter's syndrome; Syndrome; Tibia - diagnostic imaging; Tibia - pathology; transformation
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1046/j.0902-4441.2003.00198.x

: Patients with chronic lymphocytic leukemia (CLL) are at a significantly increased risk of developing a second malignant neoplasm in the course of their disease. The occurrence of large cell lymphoma [Richter's syndrome (RS)] has been described in approximately 3–5% of CLL patients. Other types of secondary lymphoid malignancies are extremely rare. Here we describe a patient, heavily pretreated, with long history of CLL who developed a secondary follicular lymphoma, transformed into a diffuse large cell lymphoma (LCL), with isolated manifestation in the bone, a very rare manifestation of RS. CLL and LCL cells were of distinct clonal origin, as documented by DNA sequencing of the CDR3 regions. Twelve months after the completion of chemo‐ and local radiotherapy, the patient is still in remission.