t(14;18)(q32;q21)-bearing pleural MALT lymphoma with IgM paraproteinemia: value of detection of specific cytogenetic abnormalities in the differential diagnosis of MALT lymphoma and lymphoplasmacytic lymphoma.
A 67-year-old woman presented with a pleural effusion and a tumor in the right pleural wall. Histological examination of thoracoscopic tumor and pleural biopsy specimens showed infiltration by medium sized cells, some of which showed plasmacytoid differentiation. In view of the presence of IgM paraproteinemia and bone marrow involvement by lymphoma cells, the patient was diagnosed tentatively as having lymphoplasmacytic lymphoma (LPL). However, chromosomal analysis of the cells in the pleural fluid detected t(14;18)(q32;q21), while fluorescence in situ hybridization was positive for 11% of the MALT1 split signal. Because of the presence of characteristic genetic abnormalities and notable extranodal involvement, the patient was diagnosed as having MALT lymphoma. She was treated with three courses of cladribine and rituximab, and achieved complete regression of the tumor. In this case the detection of t(14;18)(q32;q21) involving IGH and MALT1 was useful for the differential diagnosis of LPL and MALT lymphoma.
Gomyo
Hiroshi
H
Hematology Division, Department of Medicine, Hyogo Cancer Center, Akashi, Hyogo, Japan.
Kajimoto
Kazuyoshi
K
Maeda
Akio
A
Mizuno
Ishikazu
I
Funada
Yasuhiro
Y
Koizumi
Tamio
T
Fukui
Eiji
E
Hanioka
Keisuke
K
Ogura
Michinori
M
Murayama
Tohru
T
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D020169:Caspases / Q000235:genetics; D002883:Chromosomes, Human, Pair 14 / Q000235:genetics / Q000648:ultrastructure*; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics / Q000648:ultrastructure*; D017338:Cladribine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007075:Immunoglobulin M / Q000097:blood*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D000074884:Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein; D009363:Neoplasm Proteins / Q000235:genetics; D010266:Paraproteins / Q000032:analysis*; D010997:Pleural Neoplasms / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D012074:Remission Induction; D000069283:Rituximab; D014178:Translocation, Genetic
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007143:Immunoglobulin Heavy Chains; D007075:Immunoglobulin M; D009363:Neoplasm Proteins; D010266:Paraproteins; D017338:Cladribine; D000069283:Rituximab; D020169:Caspases; C400109:MALT1 protein, human; D000074884:Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein