Simultaneous Presentation of Leukemic Non-Nodal Mantle Cell Lymphoma and Gamma-Delta T-Large Granular Lymphocytic Leukemia in a Patient with Rheumatoid Arthritis.
| Autor: | Gorodetskiy VR; Department of Intensive Methods of Therapy, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia., Probatova NA; Department of Pathology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia., Kupryshina NA; Hematopoiesis Immunology Laboratory, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia., Palshina SG; Department of Intensive Methods of Therapy, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia., Obukhova TN; Cytogenetic Laboratory, National Research Center for Hematology, Moscow, Russia., Sidorova YV; Laboratory of Molecular Hematology, National Research Center for Hematology, Moscow, Russia., Ryzhikova NV; Laboratory of Molecular Hematology, National Research Center for Hematology, Moscow, Russia., Sudarikov AB; Laboratory of Molecular Hematology, National Research Center for Hematology, Moscow, Russia. |
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| Jazyk: | angličtina |
| Zdroj: | Cancer management and research [Cancer Manag Res] 2020 Sep 30; Vol. 12, pp. 9449-9457. Date of Electronic Publication: 2020 Sep 30 (Print Publication: 2020). |
| DOI: | 10.2147/CMAR.S261910 |
| Abstrakt: | The peculiar features of T-cell large granular lymphocytic leukemia (T-LGLL) are its association with autoimmune disorders (particularly with rheumatoid arthritis (RA)) and a broad spectrum of B-cell lymphoproliferative disorders. However, association of T-LGLL with mantle cell lymphoma (MCL) is extremely rare. Here, we describe a case of an 80-year-old man admitted with suspected Felty's syndrome. The blood count showed white blood cells at 2.2×10 9 /L, with 3% neutrophils, 88% lymphocytes, and at 0.66×10 9 /L LGLs. The spleen had been removed 43 months prior to the admission due to suspected B-cell splenic lymphoma. Re-examination of the spleen revealed cyclin D1+ and SOX11- lymphocytes in the inner part of the unexpanded mantle zones of the white pulp follicles, thus displaying a so-called in situ histologic pattern of MCL, and in small clusters in the red pulp. The splenic cords were moderately expanded by lymphocytes expressing CD3, TIA1, and granzyme B but not CD4 and CD8. Monoclonal rearrangements of the immunoglobulin heavy chain gene and the T-cell receptor (TCR) gamma and delta chain genes, polyclonal rearrangements of the TCR beta chain gene, mutation of the signal transducer and activator of transctiption 3 gene (c.1940A>T; p.N647I), and t(11;14)(q13;q32) translocation were identified in the spleen sample. Flow cytometry of bone marrow revealed a population of TCR γδ+, CD3+, CD4-, CD5-, CD7+, CD8-, CD16-, CD56-, and CD57- lymphocytes. Fragment analysis demonstrated identical TCR gene clonal rearrangement patterns in the spleen and bone marrow samples. In this study, we describe the first case of simultaneous presentation of γδ T-LGLL and leukemic non-nodal MCL (L-NN-MCL) in a patient with RA and present morphological findings of L-NN-MCL in the spleen. Competing Interests: The authors declare that they have no conflicts of interest regarding this work. (© 2020 Gorodetskiy et al.) |
| Databáze: | MEDLINE |
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