Follicular center-cell lymphoma with plasmacytic differentiation, monoclonal paraprotein, and peripheral blood involvement. Recapitulation of normal B-cell development.
A patient with a nodular and diffuse small-cleaved follicular center-cell lymphoma that exhibited definite plasmacytic differentiation, a related monoclonal gammopathy, and circulating population of small lymphocytes is presented. Aside from showing that the presence of numerous plasma cells is not a reliable criterion for the diagnosis of a reactive follicular proliferation, the case is an example of a lymphoma without a block in maturation. The "neoplastic" B-cells show development to follicular center cells and beyond, to functioning plasma cells, and probably also to recirculating "memory" cells. It also suggests that plasmacytoid lymphocytic lymphomas (Lukes-Collins classification) might represent a heterogeneous group of lymphoid neoplasms with some closely related to follicular center-cell lymphomas and others more closely related to small lymphocytic lymphoma/B-cell chronic lymphocytic leukemia.
D000911:Antibodies, Monoclonal / Q000032:analysis*; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007136:Immunoglobulins / Q000032:analysis; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D010266:Paraproteins / Q000032:analysis*; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology*
D000911:Antibodies, Monoclonal; D007136:Immunoglobulins; D010266:Paraproteins