title: Sequential development of diffuse large B-cell lymphoma in a patient with angioimmunoblastic T-cell lymphoma.
abstract: Lymphoma of different histologic type can occur in the same patient. Here, we describe a 64-year-old male patient with angioimmunoblastic T-cell lymphoma (AITL) who subsequently developed diffuse large B-cell lymphoma (DLBCL). At the time of initial diagnosis, histologic examination of a left inguinal lymph node of the patient and a monoclonal pattern of TCRβ gene rearrangement showed typical features of AITL, and there was no evidence of a monoclonal B-cell population. Twenty-six months later, he had generalized lymphadenopathy and organs involvement by DLBCL. A monoclonal IgH gene rearrangement proved de novo development of secondary B-cell lymphoma and excluded relapse of a primary composite lymphoma. The in situ hybridization analysis showed Epstein-Barr-encoded RNA (EBER) sporadic positivity in sample collected from AITL but extensive positivity in the immunoblasts collected from DLBCL. Our observation supports the hypothesis that Epstein-Barr virus (EBV) is etiologically related to AITL in this case. Clonal expansion of EBV-associated DLBCL is a secondary event in AITL via EBV infection or reactivation.
authors.affiliation: State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Huang
authors.forename: Pei-Hong
authors.initials: PH
authors.lastname: Zhang
authors.forename: Yu-Huan
authors.initials: YH
authors.lastname: Gao
authors.forename: Lu-Gui
authors.initials: LG
authors.lastname: Qiu
mesh_terms: D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications* / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction