title: Concurrent juvenile myelomonocytic leukemia and T-lymphoblastic lymphoma with a shared missense mutation in NRAS.
abstract: Single cases of B- and T-lymphoblastic leukemia/lymphoma occurring after remission of JMML, and JMML occurring after remission of B-lymphoblastic leukemia have been reported in the literature. We present a unique case of a child with concurrent JMML and T-lymphoblastic lymphoma in which an identical missense mutation in NRAS was found in both the neoplastic JMML and T-LBL cells. JMML has been considered a stem cell disorder, and our case provides additional molecular evidence for a stem cell lesion underlying the two different disease phenotypes.
authors.affiliation: Department of Clinical Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Brenda
authors.initials: B
authors.lastname: Ly
authors.forename: Arunkumar
authors.initials: A
authors.lastname: Modi
authors.forename: Heesun J
authors.initials: HJ
authors.lastname: Rogers
authors.forename: Hideki
authors.initials: H
authors.lastname: Makishima
authors.forename: Rabi
authors.initials: R
authors.lastname: Hanna
authors.forename: James R
authors.initials: JR
authors.lastname: Cook
authors.forename: Karl S
authors.initials: KS
authors.lastname: Theil
authors.forename: Jaroslaw P
authors.initials: JP
authors.lastname: Maciejewski
mesh_terms: D016026:Bone Marrow Transplantation; D002675:Child, Preschool; D020732:Cytogenetic Analysis; D020558:GTP Phosphohydrolases / Q000235:genetics*; D006801:Humans; D054429:Leukemia, Myelomonocytic, Juvenile / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D020125:Mutation, Missense / Q000235:genetics*; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D011379:Prognosis; D019172:Transplantation Conditioning
chemical_list: D008565:Membrane Proteins; D020558:GTP Phosphohydrolases; C579846:NRAS protein, human
keywords: BMT for malignant conditions; JMML; lymphoblastic lymphoma