title: Composite T lymphoblastic leukemia/lymphoma and diffuse large B-cell lymphoma: case report.
abstract: This report concerns a unique case of a composite lymphoma composed of T-lymphoblastic leukemia/lymphoma (T-LBL) and diffuse large B-cell lymphoma (DLBCL) in a 72-year-old woman with generalized lymphadenopathy, splenomegaly and ascites. Laboratory findings showed increased lactate dehydrogenase and soluble interleukin-2 receptor. The biopsy specimen showed replacement of the normal architecture of the lymph nodes by a tumor containing a dual cell population composed of large lymphocytes and medium-sized lymphocytes. Sheets of large lymphocytes often were punctuated by clusters of medium-sized lymphocytes. Flow cytometry and immunohistochemical analysis showed a composite lymphoma with both T-LBL and DLBCL. The T-LBL expressed CD1a, CD3, CD4, CD8, and terminal deoxynucleotidyl transferase. The DLBCL expressed CD19 and CD20, CD23, bcl-2, bcl-6, MUM1 and immunoglobulin κ light chain. Polymerase chain reaction detected a monoclonal pattern of T-cell receptor γ and immunoglobulin heavy chain rearrangements in the same specimen. She received eight cycles of R-CHOP (rituximab+cyclophosphamide, doxorubicin, vincristine, prednisone) therapy and achieved complete remission. She has shown no signs of recurrence 20 months after the diagnosis. We describe here a very unusual and, to the best of our knowledge, an as yet never reported case of a primary composite lymphoma of T-LBL and DLBCL.
authors: Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan. niino_daisuke@med.kurumeu.ac.jp
authors: Daisuke
authors: D
authors: Niino
authors: Koichi
authors: K
authors: Ohsaki
authors: Fumiko
authors: F
authors: Arakawa
authors: Jiro
authors: J
authors: Watanabe
authors: Yoshizo
authors: Y
authors: Kimura
authors: Junichi
authors: J
authors: Kiyasu
authors: Masanori
authors: M
authors: Takeuchi
authors: Hiroaki
authors: H
authors: Miyoshi
authors: Maki
authors: M
authors: Yoshida
authors: Yasuo
authors: Y
authors: Sugita
authors: Koichi
authors: K
authors: Ohshima
authors: Takashi
authors: T
authors: Okamura