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On-line Access: 2023-08-08

Received: 2023-03-16

Revision Accepted: 2023-04-16

Crosschecked: 2023-08-08

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Xueli JIN




Fengbo HUANG


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


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.

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journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

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%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 Fengbo HUANG
%J Journal of Zhejiang University SCIENCE B
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%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2300181

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

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.




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