PMID- 22623514
OWN - NLM
STAT- MEDLINE
DCOM- 20140516
LR  - 20161125
IS  - 1097-0339 (Electronic)
IS  - 1097-0339 (Linking)
VI  - 41
IP  - 11
DP  - 2013 Nov
TI  - Follicular lymphoma transformed to "double-hit" B lymphoblastic lymphoma 
      presenting in the peritoneal fluid.
PG  - 986-90
LID - 10.1002/dc.22871 [doi]
AB  - Lymphomas showing both MYC/8q24 rearrangement and IGH@BCL2/t(14;18)(q32;q21), 
      also referred to as "double-hit" or "dual-hit" lymphomas (DHL) are rare B-cell 
      malignancies with a germinal center B-cell immunophenotype and heterogeneous 
      cytologic and histologic features. Such lymphomas may arise de novo or through 
      transformation of follicular lymphomas and are classified either as "B-cell 
      lymphoma, unclassifiable, with features intermediate between diffuse large B-cell 
      lymphoma (DLBCL) and Burkitt lymphoma (BL)" (most commonly), DLBCL, or, rarely, 
      as B-lymphoblastic lymphoma. We report a case of B-lymphobastic lymphoma arising 
      through transformation of follicular lymphoma diagnosed on peritoneal fluid 
      cytology, flow cytometry, and cytogenetic studies in a 53-year-old man who 
      presented with abdominal pain, shortness of breath, night sweats, extensive 
      lymphadenopathy, pleural effusion, and ascites. Cytologic examination of the 
      ascitic fluid showed two distinct populations of neoplastic lymphoid cells, a 
      predominant population of larger cells with fine powdery ("blastic") chromatin, 
      visible to prominent nucleoli and occasional small cytoplasmic vacuoles and a 
      less numerous population of smaller cells with centrocytic morphology. Flow 
      cytometry also showed two distinct monotypic B-cell populations, both expressing 
      CD10, and TdT-positivity was demonstrated immunohistochemically. Fluorescence in 
      situ hybridization (FISH) demonstrated both MYC rearrangement and IGH/BCL2 gene 
      fusion and cytogenetic analysis showed a complex karyotype including both 
      t(14;18)(q32;q21) and t(8;22)(q24.1;q11.2). Since DHL pursue an aggressive 
      clinical course, respond poorly to therapy, and have a poor outcome, it is 
      important to suspect the diagnosis when encountering neoplastic lymphoid cells 
      that are difficult to classify in effusion cytology specimens and to order the 
      appropriate immunophenotyping and cytogenetic studies.
CI  - Copyright (c) 2012 Wiley Periodicals, Inc.
FAU - Kaplan, Alesia
AU  - Kaplan A
AD  - Department of Laboratory Medicine and Pathology, University of Minnesota Medical 
      School, Minneapolis, Minnesota.
FAU - Samad, Arbaz
AU  - Samad A
FAU - Dolan, Michelle M
AU  - Dolan MM
FAU - Cioc, Adina M
AU  - Cioc AM
FAU - Holman, Carol J
AU  - Holman CJ
FAU - Schmechel, Stephen C
AU  - Schmechel SC
FAU - Pambuccian, Stefan E
AU  - Pambuccian SE
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20120524
PL  - United States
TA  - Diagn Cytopathol
JT  - Diagnostic cytopathology
JID - 8506895
RN  - 0 (Antigens, CD)
SB  - IM
MH  - Antigens, CD/metabolism
MH  - Ascitic Fluid/pathology
MH  - Humans
MH  - Lymphoma, Follicular/*diagnostic imaging/metabolism/pathology
MH  - Male
MH  - Middle Aged
MH  - Pleural Effusion, Malignant/*diagnostic imaging/metabolism/pathology
MH  - Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/*diagnostic 
      imaging/metabolism/pathology
MH  - Radiography
OTO - NOTNLM
OT  - FISH
OT  - cytology
OT  - double-hit
OT  - flow cytometry
OT  - malignant lymphoma
OT  - peritoneal fluid
EDAT- 2012/05/25 06:00
MHDA- 2014/05/17 06:00
CRDT- 2012/05/25 06:00
PHST- 2011/08/11 00:00 [received]
PHST- 2012/03/29 00:00 [accepted]
PHST- 2012/05/25 06:00 [entrez]
PHST- 2012/05/25 06:00 [pubmed]
PHST- 2014/05/17 06:00 [medline]
AID - 10.1002/dc.22871 [doi]
PST - ppublish
SO  - Diagn Cytopathol. 2013 Nov;41(11):986-90. doi: 10.1002/dc.22871. Epub 2012 May 
      24.