Dual rearrangement of immunoglobulin and T-cell receptor genes in a case of splenic lymphoma with villous lymphocytes.
We report here a case of "splenic lymphoma with villous lymphocytes" (SLVL) which exhibited both B- and T-cell phenotypes and genotypes. The patient was a 73-year-old man. Physical examination revealed splenomegaly and lymphadenopathy. The white blood cell count was 55.2 x 10(9)/L with 70.5% atypical lymphocytes, having cytoplasmic villi, characteristic of SLVL. The atypical cells infiltrated both the red and white pulps. Immunological analysis of the peripheral leukocytes showed both B- and T-cell phenotypes (CD5,CD11c,CD19,CD20,HLA-DR, SmIgM and lambda positive). DNA analysis revealed a dual rearrangement of the immunoglobulin heavy chain gene and T-cell receptor beta gene. SLVL has been identified as a B-cell leukemia with a relatively benign clinical course. This case had both B- and T-cell pheno- and genotypes with a progressive course. To the best of our knowledge, no case of SLVL with dual genotypes has ever been reported.
3rd Dept. of Internal Med., Nippon Medical School, Tokyo, Japan.
H
H
Hanawa
J
J
Abo
K
K
Inokuchi
S
S
Tanosaki
H
H
Matuoka
K
K
Miyake
M
M
Futaki
K
K
Dan
T
T
Nomura
D000368:Aged; D015703:Antigens, CD / Q000097:blood; D001402:B-Lymphocytes / Q000648:ultrastructure; D004273:DNA, Neoplasm / Q000235:genetics; D015321:Gene Rearrangement; D015329:Gene Rearrangement, T-Lymphocyte; D005803:Genes, Immunoglobulin; D005838:Genotype; D006801:Humans; D016130:Immunophenotyping; D016393:Lymphoma, B-Cell / Q000235:genetics* / Q000648:ultrastructure; D008297:Male; D008871:Microvilli; D013160:Splenic Neoplasms / Q000097:blood / Q000235:genetics* / Q000648:ultrastructure; D013601:T-Lymphocytes / Q000648:ultrastructure
D015703:Antigens, CD; D004273:DNA, Neoplasm