Sequential development of Hodgkin's disease and CD30+ diffuse large B-cell lymphoma in a patient with MALT-type lymphoma: evidence of different clonal origin of single microdissected Reed-Sternberg cells.
We observed in the same patient the development of a tonsil mucosa-associated lymphoid tissue-type lymphoma in 1994, a mediastinal Hodgkin's disease in 1998, and a colonic CD30+ anaplastic diffuse large B-cell lymphoma in 2000. A same-sized FR3-JH fragment was demonstrated by polymerase chain reaction, both at the level of total DNA and of single micromanipulated cells, showing monocytoid, Reed-Sternberg, or anaplastic morphology. Moreover, an identical IgH nucleotide sequence was detected in mucosa-associated lymphoid tissue-type lymphoma and colonic CD30+ anaplastic diffuse large B-cell lymphoma, whereas mediastinal Hodgkin's disease IgH rearrangement involved different VH and JH genes. CD30+ Reed-Sternberg and diffuse large B-cell lymphoma cells contained Epstein-Barr virus EBER sequences that were not observed at the level of mucosa-associated lymphoid tissue-type lymphoma. Therefore, Epstein-Barr virus infection may have played a role in diffuse large B-cell lymphoma transformation of mucosa-associated lymphoid tissue-type lymphoma and in the lymphomagenesis of Hodgkin's disease. In addition to their different clonal origin, Reed-Sternberg cells of Hodgkin's disease expressed a CD15+, CD20+ (rare cells), CD30+, Oct-2-, EBNA2-, LMP1+ phenotype, whereas anaplastic and Reed-Sternberg-like cells of diffuse large B-cell lymphoma were CD15-, CD20+, CD30+, Oct-2+, EBNA2+, and LMP1+. Interestingly, we also detected scattered CD30+ Epstein-Barr virus- large cells with prominent nucleoli in the initial tonsil mucosa-associated lymphoid tissue-type lymphoma, suggesting that these cells could be prone to Epstein-Barr virus infection and/or large cell transformation.
Parrens
Marie
M
Department of Pathology and Molecular Biology, CHU and University of Bordeaux 2, Bat 3B, 146 rue Léo Saignat, 33076 Bordeaux, France. marie.parrens@chu-bordeaux.fr
Vergier
Béatrice
B
Fitoussi
Olivier
O
Lahet
Chantal
C
Belleannee
Geneviève
G
Marit
Gérald
G
Dubus
Pierre
P
de Mascarel
Antoine
A
Delfau-Larue
Marie Hélène
MH
Merlio
Jean Philippe
JP
D004273:DNA, Neoplasm / Q000032:analysis; D018450:Disease Progression; D015321:Gene Rearrangement; D006689:Hodgkin Disease / Q000150:complications / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics; D016130:Immunophenotyping; D017730:Ki-1 Antigen / Q000032:analysis*; D016393:Lymphoma, B-Cell / Q000150:complications / Q000276:immunology / Q000473:pathology*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications* / Q000276:immunology / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
D004273:DNA, Neoplasm; D007136:Immunoglobulins; D017730:Ki-1 Antigen