Multiple cutaneous monoclonal B-cell proliferations as harbingers of systemic angioimmunoblastic T-cell lymphoma.
We describe a 66-year-old man initially diagnosed with primary cutaneous marginal zone B-cell lymphoma who developed four additional monoclonal/monotypic B-cell lymphoid proliferations and a systemic angioimmunoblastic T-cell lymphoma over the course of 19 months. Through retrospective analysis, we identified the evolution of a T-cell clone within the background of clinically and pathologically dominant cutaneous B-cell tumors. In terms of clinical practice, this case supports that patients diagnosed with multiple clonal B-cell proliferation need thorough investigation and close clinical follow up to identify a coexistent or evolving systemic lymphoma, in particular, peripheral T-cell lymphomas of follicular T-helper cell type, such as angioimmunoblastic T-cell lymphoma. Biologically, this case offers unique insight into the interactions between B-cell and T-cell lineages in lymphoid neoplasia.
Bayerl
Michael G
MG
Department of Pathology, Penn State Hershey Medical Center, Hershey, PA 17033, USA.
Hennessy
Jeannie
J
Ehmann
William Christopher
WC
Bagg
Adam
A
Rosamilia
Lorraine
L
Clarke
Loren E
LE
D000368:Aged; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000473:pathology*; D016410:Lymphoma, T-Cell, Cutaneous / Q000235:genetics / Q000473:pathology*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011948:Receptors, Antigen, T-Cell / Q000235:genetics; D012878:Skin Neoplasms / Q000235:genetics / Q000473:pathology*
D007143:Immunoglobulin Heavy Chains; D011948:Receptors, Antigen, T-Cell