Chronic lymphocytic leukemia with paraimmunoblastic transformation - with comparative genomic hybridization and review of the literature.
Richter's transformation (RT) is the development of a high-grade lymphoma in patients with B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). We report an extremely rare case with paraimmunoblastic transformation. A 78-year-old Taiwanese male had Rai stage 1 and Binet stage B CLL/SLL involving skin, peripheral blood (PB), and bone marrow (BM) with paraimmunoblastic transformation in the lymph node. Molecular/genomic studies showed the same clonal origin of tumor tissues at various locations with trisomy 12 and a deletion of chromosome 13q14. Interestingly, there seemed to be no additional chromosomal aberrations in the transformed nodal tissue, suggesting that the micro-environment rather than an additional genetic lesion contributed to the transformation. The patient received chemotherapy and was alive with disease after 33.5 months.
Department of Pathology, Chi-Mei Medical Center, Yung-Kang City 710, Tainan County, Taiwan. cmh5301@mail.chimei.org.tw
Shih-Sung
SS
Chuang
Yung-Liang
YL
Liao
Chiou-Ping
CP
Liou
Michele L
ML
Wiggins
Hongtao
H
Ye
Ming-Qing
MQ
Du
Peter G
PG
Isaacson
Chung-Che
CC
Chang
D000368:Aged; D001402:B-Lymphocytes / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000235:genetics* / Q000473:pathology; D055028:Comparative Genomic Hybridization; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D014314:Trisomy / Q000235:genetics / Q000473:pathology