title: Intravascular large B-cell lymphoma secondary to lymphoplasmacytic lymphoma: a case report and review of literature with clonality analysis.
abstract: Intravascular large B-cell lymphoma (IVLBCL) can be a fatal malignancy mainly because of difficulty in early detection. Due to the lack of specific clinical manifestations, early detection of IVLBCL remains a challenge, especially in the presence of comorbidities. Lymphoplasmacytic lymphoma (LPL) is an indolent B-cell lymphoma accompanied by monoclonal immunoglobulin M protein in most patients, and known to be associated with high risk of secondary hematological malignancies. Here, we report a patient who developed IVLBCL during treatment for LPL that presented a diagnostic challenge. Rearrangement analysis of the immunoglobulin heavy chain revealed the different clonal origins of two lymphomas, implying a predisposition of LPL to develop unrelated secondary lymphoma. Secondary lymphoma including IVLBCL during the treatment for LPL deserves consideration in order to facilitate early diagnosis and intervention.
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Department of Pathology and Clinical Laboratory, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Akiko Miyagi
authors.initials: AM
authors.lastname: Maeshima
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan ; Department of Internal Medicine, Dong-A University College of Medicine Busan, South Korea.
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Nomoto
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Fukuhara
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kitahara
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Munakata
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Maruyama
authors.affiliation: Department of Hematology, National Cancer Center Hospital 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
mesh_terms: D000368:Aged; D018951:Antigens, CD20 / Q000032:analysis; D001344:Autopsy; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics*; D001706:Biopsy; D017809:Fatal Outcome; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D050438:Genes, Immunoglobulin Heavy Chain; D020022:Genetic Predisposition to Disease; D006801:Humans; D007150:Immunohistochemistry; D016393:Lymphoma, B-Cell / Q000235:genetics* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D008297:Male; D010641:Phenotype; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D013997:Time Factors; D019043:Vascular Neoplasms / Q000235:genetics* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D008258:Waldenstrom Macroglobulinemia / Q000235:genetics* / Q000276:immunology / Q000473:pathology / Q000628:therapy
chemical_list: D018951:Antigens, CD20; D014408:Biomarkers, Tumor
keywords: Intravascular large B-cell lymphoma; immunoglobulin rearrangement; lymphoplasmacytic lymphoma; secondary lymphoma