title: The utility of B-cell receptor gene rearrangement studies in diagnosing diffuse large B-cell lymphoma with plasmacytic differentiation.
abstract: We present the case of a 50-year-old man with nodal diffuse large B-cell lymphoma characterized by CD10, BCL-6, and BCL-2 expression and a complex karyotype, including t(14;18)(q32;q21) and del6q, suggesting transformation from an antecedent follicular lymphoma. Following rituximab-based chemotherapy, residual nodal disease was characterized by a proliferation of plasmacytoid cells positive for CD138, MUM-1, and cytoplasmic kappa light chain. Immunoglobulin heavy chain and kappa light chain gene rearrangement studies detected the same clone in the diagnostic and post-therapy lymph node specimens. This case illustrates the diagnostic utility of B-cell receptor gene rearrangement studies in detecting a clonal relationship in lymphoma cases with extensive morphologic and immunophenotypic variation following chemotherapy.
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Daisy V
authors.initials: DV
authors.lastname: Alapat
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Ramos
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA gpost@uams.edu.
authors.forename: Ginell R
authors.initials: GR
authors.lastname: Post
mesh_terms: D002454:Cell Differentiation; D015322:Gene Rearrangement, B-Lymphocyte; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011947:Receptors, Antigen, B-Cell / Q000235:genetics*; D060152:V(D)J Recombination / Q000235:genetics
chemical_list: D011947:Receptors, Antigen, B-Cell
keywords: B cell receptor gene rearrangement; Diffuse large B cell lymphoma; plasmacytic differentiation