title: Epstein-Barr virus-positive diffuse large B-cell lymphoma following acute myeloid leukemia: a common clonal origin indicated by chromosomal translocation t(3;4)(p25;q21).
abstract: Secondary non-Hodgkin lymphoma following acute myeloid leukemia (AML) is extremely rare. We here describe a unique case involving a patient who developed Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) during complete remission (CR) of AML. A 75-year-old Japanese man was initially diagnosed with AML with maturation (FAB M2), bearing chromosomal translocation t(3,4)(p25;q21). After intensive chemotherapy, bone marrow aspiration revealed normal karyotype, and he achieved CR. Six years and 4 months later, he was still in CR from AML, but developed DLBCL presenting in the terminal ileum. Cytogenetic analysis of the DLBCL cells showed the same translocation as the previous AML. The rearrangements of the immunoglobulin heavy chain genes of the two malignancies were examined using polymerase chain reaction amplification, and the rearrangement patterns were found to differ from each other. Our data thus suggest that, in the present case, the AML and DLBCL arose from a common progenitor cell, as indicated by the clonal abnormality t(3,4)(p25;q21), and that different immunoglobulin heavy chain gene rearrangements occurred during each course of clonal evolution.
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan. m.higuchi@jrkyushu-hospital.jp.|Department of Hematology, JR Kyushu Hospital, 1-1, Takada 2-chome, Moji-ku, Kitakyushu, Fukuoka, 800-0031, Japan. m.higuchi@jrkyushu-hospital.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Higuchi
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Kawadoko
authors.affiliation: Department of Surgery, JCHO Kyushu Hospital, Fukuoka, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Uchiyama
authors.affiliation: Department of Surgery, JCHO Kyushu Hospital, Fukuoka, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Yasui
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kamihira
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Aoki
authors.affiliation: Department of Pathology, JCHO Kyushu Hospital, Fukuoka, Japan.
authors.forename: Takakazu
authors.initials: T
authors.lastname: Sasaguri
authors.affiliation: Department of Pathology, JCHO Kyushu Hospital, Fukuoka, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Nakano
authors.affiliation: Department of Surgery, JCHO Kyushu Hospital, Fukuoka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uchiyama
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Muta
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
mesh_terms: D000368:Aged; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics*; D002894:Chromosomes, Human, Pair 4 / Q000235:genetics*; D020031:Epstein-Barr Virus Infections / Q000235:genetics*; D004854:Herpesvirus 4, Human; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics* / Q000821:virology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics* / Q000821:virology; D008297:Male; D016609:Neoplasms, Second Primary / Q000235:genetics* / Q000821:virology; D014178:Translocation, Genetic
keywords: Acute myeloid leukemia; Clonality; Diffuse large B-cell lymphoma; Epstein–Barr virus; Immunoglobulin heavy chain