Full Text:   <510>

Summary:  <236>

CLC number: 

On-line Access: 2023-08-08

Received: 2023-03-16

Revision Accepted: 2023-04-16

Crosschecked: 2023-08-08

Cited: 0

Clicked: 716

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Xueli JIN

https://orcid.org/0000-0001-5618-920X

Yun LIANG

https://orcid.org/0000-0002-9215-1708

Fengbo HUANG

https://orcid.org/0000-0002-5548-3156

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2023 Vol.24 No.8 P.711-722

http://doi.org/10.1631/jzus.B2300181


Composite B-cell and T-cell lymphomas: clinical, pathological, and molecular features of three cases and literature review


Author(s):  Xueli JIN, Hui LIU, Jing LI, Xibin XIAO, Xianggui YUAN, Panpan CHEN, Boxiao CHEN, Yun LIANG, Fengbo HUANG

Affiliation(s):  Department of Hematology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; more

Corresponding email(s):   liangyun@zju.edu.cn, 2515183@zju.edu.cn

Key Words:  Composite lymphoma, B-cell lymphoma, T-cell lymphoma


Xueli JIN, Hui LIU, Jing LI, Xibin XIAO, Xianggui YUAN, Panpan CHEN, Boxiao CHEN, Yun LIANG, Fengbo HUANG. Composite B-cell and T-cell lymphomas: clinical, pathological, and molecular features of three cases and literature review[J]. Journal of Zhejiang University Science B, 2023, 24(8): 711-722.

@article{title="Composite B-cell and T-cell lymphomas: clinical, pathological, and molecular features of three cases and literature review",
author="Xueli JIN, Hui LIU, Jing LI, Xibin XIAO, Xianggui YUAN, Panpan CHEN, Boxiao CHEN, Yun LIANG, Fengbo HUANG",
journal="Journal of Zhejiang University Science B",
volume="24",
number="8",
pages="711-722",
year="2023",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2300181"
}

%0 Journal Article
%T Composite B-cell and T-cell lymphomas: clinical, pathological, and molecular features of three cases and literature review
%A Xueli JIN
%A Hui LIU
%A Jing LI
%A Xibin XIAO
%A Xianggui YUAN
%A Panpan CHEN
%A Boxiao CHEN
%A Yun LIANG
%A Fengbo HUANG
%J Journal of Zhejiang University SCIENCE B
%V 24
%N 8
%P 711-722
%@ 1673-1581
%D 2023
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2300181

TY - JOUR
T1 - Composite B-cell and T-cell lymphomas: clinical, pathological, and molecular features of three cases and literature review
A1 - Xueli JIN
A1 - Hui LIU
A1 - Jing LI
A1 - Xibin XIAO
A1 - Xianggui YUAN
A1 - Panpan CHEN
A1 - Boxiao CHEN
A1 - Yun LIANG
A1 - Fengbo HUANG
J0 - Journal of Zhejiang University Science B
VL - 24
IS - 8
SP - 711
EP - 722
%@ 1673-1581
Y1 - 2023
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B2300181


Abstract: 
composite lymphoma (CL) involving b-cell lymphoma and t-cell lymphoma is extremely rare. Herein, we report three such cases using immunohistochemistry, flow cytometry, and the next-generation sequencing (NGS) to identify the pathological and molecular characteristics of CL. In the first case, the patient was admitted to hospital for generalized pruritic maculopapular rash over the whole body. An excisional biopsy of the skin lesions showed t-cell lymphoma. At the same time, the staging bone marrow (BM) biopsy revealed a diffuse large b-cell lymphoma (DLBCL). After R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapies, the patient produced a good response with substantial dissipation of the rashes and relief of skin. The other two patients were admitted to hospital due to lymphadenopathy and were diagnosed with DLBCL and follicular lymphoma (FL) after core needle biopsy of lymph nodes, BM biopsy, BM aspiration, and flow cytometry. Following R-CHOP and R-COP (rituximab, cyclophosphamide, vincristine, and prednisone) therapies, they achieved complete remission unconfirmed (CRu) and complete remission (CR). However, one or two years later, they suffered a relapse of lymphadenopathy. The shocking fact was that re-biopsy of lymphadenopathy revealed peripheral t-cell lymphoma (PTCL) and angioimmunoblastic t-cell lymphoma (AITL). NGS findings identified DNA methyltransferase 3a (DNMT3a), isocitrate dehydrogenase 2 (IDH2), Ras homolog gene family, member A (RHOA), splicing factor 3B subunit 1 (SF3B1), and tumor protein p53 (TP53) mutations. After immunochemotherapy, these patients achieved CRu and CR again. Nevertheless, they suffered a second relapse of t-cell lymphoma. Finally, they died due to progression of disease. We found that the occurrence of CL is associated with Epstein-Barr virus infection and DNMT3a, IDH2, and TP53 mutations, and the prognosis of the disease is closely related to the t-cell lymphoma components.

三例复合性B细胞和T细胞淋巴瘤患者的临床、病理和分子学特征的分析及文献回顾

金雪立1,刘辉2,李晶3,肖希斌1,袁相贵1,陈攀攀1,陈博晓4,梁赟1,黄封博2
1浙江大学医学院附属第二医院血液科,中国杭州市,310009
2浙江大学医学院附属第二医院病理科,中国杭州市,310009
3浙江大学医学院附属第二医院核医学科,中国杭州市,310009
4浙江大学医学院,中国杭州市,310029
摘要:复合性B细胞和T细胞淋巴瘤发病率很低。为了研究复合性淋巴瘤的临床、病理和分子学特征,本文报道了三例复合性B细胞和T细胞淋巴瘤患者,并通过免疫组化、流式细胞术和二代测序检测分析患者的病理和分子学特征。第一例患者通过皮肤活检、骨髓活检和流式细胞术明确诊断为皮肤T细胞淋巴瘤和骨髓弥漫大B细胞淋巴瘤。另外两例患者通过淋巴结粗针穿刺活检和骨髓活检明确诊断为B细胞淋巴瘤,但疾病复发后再次经过病理活检明确诊断为T细胞淋巴瘤,同时二代测序检测发现了DNA甲基转移酶3a(DNMT3a)和肿瘤蛋白p53(TP53)等基因突变。在此基础上,本文回顾了复合性淋巴瘤的相关文献,并总结了复合性B细胞和T细胞淋巴瘤的临床、病理和分子特征。我们发现复合性淋巴瘤的发病和EB病毒感染,以及DNMT3a、异柠檬酸脱氢酶2(IDH2)和TP53突变等相关,同时该疾病的预后与侵袭性更高的T细胞淋巴瘤成分密切相关。

关键词:复合性淋巴瘤;B细胞淋巴瘤;T细胞淋巴瘤

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]AmaraK, ZiadiS, HachanaM, et al., 2010. DNA methyltransferase DNMT3b protein overexpression as a prognostic factor in patients with diffuse large B-cell lymphomas. Cancer Sci, 101(7):1722-1730.

[2]BalaguéO, MartínezA, ColomoL, et al., 2007. Epstein-Barr virus negative clonal plasma cell proliferations and lymphomas in peripheral T-cell lymphomas: a phenomenon with distinctive clinicopathologic features. Am J Surg Pathol, 31(9):1310-1322.

[3]ChunSM, SungCO, JeonH, et al., 2018. Next-generation sequencing using S1 nuclease for poor-quality formalin-fixed, paraffin-embedded tumor specimens. J Mol Diagn, 20(6):802-811.

[4]ClearyML, SklarJ, 1984. Lymphoproliferative disorders in cardiac transplant recipients are multiclonal lymphomas. Lancet, 324(8401):489-493.

[5]CouronnéL, BastardC, BernardOA, 2012. TET2 and DNMT3A mutations in human T-cell lymphoma. N Engl J Med, 366(1):95-96.

[6]CusterR, 1954. Pitfalls in the diagnosis of lymphoma and leukemia from the pathologist’s point of view. Proceeding of the Second National Cancer Conference. American Cancer Society, New York, p.554-557.

[7]HuE, WeissLM, WarnkeR, et al., 1987. Non-Hodgkin’s lymphoma containing both B and T cell clones. Blood, 70(1):287-292.

[8]KämmererU, KappM, GasselAM, et al., 2001. A new rapid immunohistochemical staining technique using the EnVision antibody complex. J Histochem Cytochem, 49(5):623-630.

[9]KimH, HendricksonMR, DorfmanRF, 1977. Composite lymphoma. Cancer, 40(3):959-976. https://doi.‍org/10.1002/1097-0142(197709)40:‍3<959::‍aid-cncr2820400302>3.0.co;2-3

[10]KüppersR, DührsenU, HansmannML, 2014. Pathogenesis, diagnosis, and treatment of composite lymphomas. Lancet Oncol, 15(10):e435-e446.

[11]LuoC, YuT, YoungKH, et al., 2022. HDAC inhibitor chidamide synergizes with venetoclax to inhibit the growth of diffuse large B-cell lymphoma via down-regulation of MYC, BCL2, and TP53 expression. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 23(8):666-681.

[12]OdejideO, WeigertO, LaneAA, et al., 2014. A targeted mutational landscape of angioimmunoblastic T-cell lymphoma. Blood, 123(9):1293-1296.

[13]OnaindiaA, Santiago-QuispeN, Iglesias-MartinezE, et al., 2021. Molecular update and evolving classification of large B-cell lymphoma. Cancers, 13(13):3352.

[14]RappaportH, WinterWJ, HicksEB, 1956. Follicular lymphoma. A re-evaluation of its position in the scheme of malignant lymphoma based on a survey of 253 cases. Cancer, 9(4):792-821.

[15]SuefujiN, NiinoD, ArakawaF, et al., 2012. Clinicopathological analysis of a composite lymphoma containing both T- and B-cell lymphomas. Pathol Int, 62(10):690-698.

[16]TanakaJ, SuP, LuedkeC, et al., 2018. Composite lymphoma of follicular B-cell and peripheral T-cell types with distinct zone distribution in a 75-year-old male patient: a case study. Hum Pathol, 76:110-116.

[17]ThirumalaS, EspositoM, FuchsA, 2000. An unusual variant of composite lymphoma: a short case report and review of the literature. Arch Pathol Lab Med, 124(9):‍1376-1378.

[18]TrimechM, LetourneauA, MissiagliaE, et al., 2021. Angioimmunoblastic T-cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: a novel form of composite lymphoma potentially mimicking Richter syndrome. Am J Surg Pathol, 45(6):773-786.

[19]WangED, PapavassiliouP, WangAR, et al., 2014. Composite lymphoid neoplasm of B-cell and T-cell origins: a pathologic study of 14 cases. Hum Pathol, 45(4):768-784.

[20]WhitlingNA, ShanesmithRP, JacobL, et al., 2013. Composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient. Hum Pathol, 44(4):670-675.

[21]WolfeJA, BorowitzMJ, 1984. Composite lymphoma: a unique case with two immunologically distinct B-cell neoplasms. Am J Clin Pathol, 81(4):526-529.

[22]XieCQ, LiX, ZengH, et al., 2020. Molecular insights into pathogenesis and targeted therapy of peripheral T cell lymphoma. Exp Hematol Oncol, 9:30.

[23]XuY, McKennaRW, HoangMP, et al., 2002. Composite angioimmunoblastic T-cell lymphoma and diffuse large B-cell lymphoma: a case report and review of the literature. Am J Clin Pathol, 118(6):848-854.

[24]ZettlA, LeeSS, RüdigerT, et al., 2002. Epstein-Barr virus-associated B-cell lymphoproliferative disorders in angioimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma, unspecified. Am J Clin Pathol, 117(3):368-379.

[25]ZhangB, ZhangYY, LiQ, et al., 2022. Case report: chronic lymphocytic leukemia/small lymphocytic lymphoma and monomorphic epitheliotropic intestinal T-cell lymphoma: a composite lymphoma. Pathol Oncol Res, 28:1610653.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE