Splenic B-Cell Lymphomas with Diffuse Cyclin D1 Protein Expression and Increased Prolymphocytic Cells: A Previously Unrecognized Diagnostic Pitfall

Prolymphocytic transformation is a concept usually applied in the context of chronic lymphocytic leukemia/small lymphocytic lymphoma to describe the presence of a high percentage of prolymphocytes in peripheral blood (usually more than 55%). Prolymphocytic transformation has also been reported in ma...

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Published inCase reports in hematology Vol. 2018; no. 2018; pp. 1 - 9
Main Authors Chapman-Fredericks, Jennifer, Vega, Francisco, Alderuccio, Juan P, Rosenblatt, Joseph D., Peng, Jing-Hong, Alencar, Alvaro, Mackrides, Nicolas, Tan, Yaohong, Algashaamy, Khaled, Lossos, Izidore S.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 01.01.2018
Hindawi
John Wiley & Sons, Inc
Hindawi Limited
Subjects
B cells
Blood
Bone marrow
Case Report
Case reports
Cytoplasm
Diagnosis
DNA methylation
Flow cytometry
Leukemia
Lymphatic system
Lymphoma
Medical prognosis
Mutation
Non-Hodgkin's lymphomas
Protein expression
Proteins
Vincristine
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Summary:Prolymphocytic transformation is a concept usually applied in the context of chronic lymphocytic leukemia/small lymphocytic lymphoma to describe the presence of a high percentage of prolymphocytes in peripheral blood (usually more than 55%). Prolymphocytic transformation has also been reported in mantle cell lymphoma (MCL) but only rarely in splenic marginal zone lymphoma (SMZL). We present two splenic B-cell lymphomas presenting in the leukemic phase and with increased prolymphocytes, both classified as SMZL with prolymphocytic transformation. One case clinically simulated B-prolymphocytic leukemia (B-PLL). Both lymphomas were very unusual because the tumor cells diffusely and strongly expressed cyclin D1 despite lacking the t(11; 14)(q13; q32) as detected by several approaches including next-generation sequencing, fluorescence in situ hybridization using CCND1 break apart probe and fusion probes for t(11; 14)(q13; q32), and conventional karyotyping. These cases therefore simulated prolymphocytic variants of MCL. The incidence of this phenomenon is unknown, and awareness of this potential alternate protein expression pattern is important in order to avoid diagnostic errors.
Bibliography:Academic Editor: Kostas Konstantopoulos
ISSN:2090-6560
2090-6579
DOI:10.1155/2018/5761953