title: A case of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma in a Korean child.
abstract: B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL) (intermediate DLBCL/BL), is a heterogeneous group with some features resembling DLBCL and others resembling BL. Here, we report a case of intermediate DLBCL/BL in a Korean child. A 2-yr-old male was admitted for evaluation and management of left hip pain. Immunohistochemistry of a biopsy of the femur neck revealed tumor cells positive for CD20, CD10, BCL2, BCL6, and Ki67. A bone marrow (BM) aspirate smear revealed that 49.3% of all nucleated cells were abnormal lymphoid cells, composed of large- and medium-sized cells. Immunophenotyping of the neoplastic cells revealed positivity for CD19, CD10, CD20, and sIg lambda and negativity for CD34, Tdt, and myeloperoxidase (MPO). Cytogenetic and FISH analyses showed a complex karyotype, including t(8;14)(q24.1;q32) and IGH-MYC fusion. Intensive chemotherapy was initiated, including prednisone, vincristine, L-asparaginase, daunorubicin, and central nervous system prophylaxis with intrathecal methotrexate (MTX) and cytarabine. One month after the initial diagnosis, BM examination revealed the persistent of abnormal lymphoid cells; cerebrospinal fluid cytology, including cytospin, showed atypical lymphoid cells. The patient was treated again with cyclophosphamide, vincristine, prednisone, adriamycin, MTX, and intrathecal MTX and cytarabine. The patient died of sepsis 5 months after the second round of chemotherapy.
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea. jyahn@gilhospital.com
authors.forename: Jeong Yeal
authors.initials: JY
authors.lastname: Ahn
authors.forename: Yiel Hea
authors.initials: YH
authors.lastname: Seo
authors.forename: Pil Whan
authors.initials: PW
authors.lastname: Park
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Park
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Jeong
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Song
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001854:Bone Marrow Cells / Q000473:pathology; D002675:Child, Preschool; D002883:Chromosomes, Human, Pair 14; D002898:Chromosomes, Human, Pair 8; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005272:Femur Neck / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011239:Prednisolone / Q000627:therapeutic use; D056910:Republic of Korea; D014178:Translocation, Genetic; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D015514:Oncogene Proteins, Fusion; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D008727:Methotrexate