title: Heterogeneity of histological transformation events in Waldenström's macroglobulinemia (WM) and related disorders.
abstract: Histological transformation, typically to diffuse large B-cell lymphoma (DLBCL) is reported to occur in 5%-10% of patients with WM and recent studies have highlighted a possible aetiological role for the nucleoside analogues. It is however becoming increasingly clear that histological transformation is a complex phenomenon and may include clonally unrelated disorders. In order to highlight this pathological heterogeneity we describe 5 patients with diverse histological progression events. These included EBV-associated events namely DLBCL, peripheral T-cell lymphoma and spontaneously resolving mucocutaneous ulcer. A further 2 patients demonstrated a localised plasma cell rich lesion simulating plasmacytoma and a de novo DLBCL arising in an unrelated B-cell clone. It is clear therefore that detailed pathological assessments are required in all suspected cases of transformation and that the pathological heterogeneity demonstrated by this study needs to be taken into account when potential aetiological factors are being assessed.
authors.affiliation: HMDS Laboratory, St James's Institute of Oncology, Leeds. rgowen@hmds.org.uk
authors.forename: R G
authors.initials: RG
authors.lastname: Owen
authors.forename: A G
authors.initials: AG
authors.lastname: Bynoe
authors.forename: A
authors.initials: A
authors.lastname: Varghese
authors.forename: R M
authors.initials: RM
authors.lastname: de Tute
authors.forename: A C
authors.initials: AC
authors.lastname: Rawstron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy / Q000473:pathology*