t(2;5) positive lymphoma with peripheral blood involvement.
We report two cases of CD30 and t(2;5) positive lymphomas with peripheral blood (PB) involvement. Case one demonstrated the histological appearance of a diffuse large cell lymphoma with disease in the bone marrow (BM) and PB. Immunoperoxidase stains of the BM for CD30 proved to be of value in detecting disease. RT-PCR for the t(2;5) translocation product was positive in the PB, BM and lymph node. Case two had a typical anaplastic large cell lymphoma (ALCL) morphology, with a suboptimal BM biopsy, but abnormal circulating cells in the PB showing the presence of the NPM/ALK fusion product demonstrated by RT-PCR. The first case demonstrates that not all CD30 positive and t(2;5)-associated lymphomas have an anaplastic appearance. Routine staining for CD30 and EMA in BM biopsies is useful for pathological staging. The significance of the t(2;5) in defining a specific histological subtype is unclear. RT-PCR for the t(2;5) is a more sensitive test to detect disease in PB and BM as compared with light microscopy. The clinical significance of molecular staging for patients with ALCL using RT-PCR needs to be evaluated.
Chhanabhai
M
M
Department of Pathology, British Columbia Cancer Agency and University of British Columbia, Vancouver, Canada.
Britten
C
C
Klasa
R
R
Gascoyne
R D
RD
D000328:Adult; D002889:Chromosomes, Human, Pair 2; D002895:Chromosomes, Human, Pair 5; D006801:Humans; D007124:Immunoenzyme Techniques; D017730:Ki-1 Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology; D017728:Lymphoma, Large-Cell, Anaplastic / Q000235:genetics* / Q000473:pathology; D008297:Male; D016133:Polymerase Chain Reaction; D014178:Translocation, Genetic
D017730:Ki-1 Antigen