title: Immunodeficiency-associated malignant lymphoma. Three cases showing genotypic evidence of both T- and B-cell lineages.
abstract: Dual rearrangement of both immunoglobulin and T-cell receptor (TCR) genes has been described in up to 30% of precursor lymphoid neoplasms, but this phenomenon occurs rarely in lymphomas with a mature phenotype. We describe three cases of immunodeficiency-associated lymphomas, two in patients with acquired immunodeficiency syndrome (AIDS) and one in a patient with a renal transplant, in which both immunoglobulin and TCR gene rearrangements were identified. Two cases exhibited clonal JH, clonal JK, and clonal TCR beta gene rearrangements; the other case had clonal JK and TCR beta gene rearrangements with deletion of JH. Two of these bigenotypic lesions exhibited a B-cell phenotype, and the other exhibited evidence of both a B- and T-cell phenotype, containing cytoplasmic CD3 as well as monoclonal kappa light chain. In addition, two of the cases exhibited the presence of clonal Epstein-Barr viral DNA. These observations suggest that lymphomas arising in immunodeficiency states may be more prone to disordered differentiation than those arising in an intact immune system.
authors.affiliation: Laboratory of Pathology, National Cancer Institute, Bethesda, MD 20892.
authors.forename: H C
authors.initials: HC
authors.lastname: Hollingsworth
authors.forename: M
authors.initials: M
authors.lastname: Stetler-Stevenson
authors.forename: D
authors.initials: D
authors.lastname: Gagneten
authors.forename: D W
authors.initials: DW
authors.lastname: Kingma
authors.forename: M
authors.initials: M
authors.lastname: Raffeld
authors.forename: E S
authors.initials: ES
authors.lastname: Jaffe
mesh_terms: D000328:Adult; D015139:Blotting, Southern; D002648:Child; D015342:DNA Probes; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte / Q000235:genetics; D005838:Genotype; D006566:Herpesviridae Infections / Q000276:immunology / Q000473:pathology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D016130:Immunophenotyping; D017403:In Situ Hybridization; D008223:Lymphoma / Q000276:immunology* / Q000473:pathology*; D016483:Lymphoma, AIDS-Related / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000276:immunology; D016399:Lymphoma, T-Cell / Q000276:immunology; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D011946:Receptors, Antigen / Q000235:genetics; D014412:Tumor Virus Infections / Q000276:immunology / Q000473:pathology
chemical_list: D015342:DNA Probes; D012367:RNA, Viral; D011946:Receptors, Antigen