Hodgkin Variant of Richter’s Transformation in Chronic Lymphocytic leukemia (CLL): An Illustrative Case Report and Literature Review
| Autor: | Tina Dadu, Anil Handoo, Aditi Mittal, Amit Agarwal, Rajan Duggal, Nishit Gupta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Transplantation
business.industry Chronic lymphocytic leukemia Neoplasms. Tumors. Oncology. Including cancer and carcinogens Hematology medicine.disease Hodgkin's lymphoma Richter's transformation Oncology immune system diseases hemic and lymphatic diseases Cancer research medicine business Hodgkin’s Lymphoma Richter’s transformation Chronic lymphocytic leukemia (CLL) Epstein-Barr virus (EBV) Fluorodeoxyglucose positron emission tomography (FDG-PET) scan Adriamycin Bleomycin Vinblastine Dacarbazine (ABVD) chemotherapy RC254-282 |
| Zdroj: | International Journal of Hematology-Oncology and Stem Cell Research, Vol 15, Iss 4 (2021) |
| ISSN: | 2008-2207 |
| Popis: | Hodgkin lymphoma variant of Richter’s transformation (HL-RT) is a rare event, occurring in < 1% chronic lymphocytic leukemia (CLL) cases, of which, in < 10% cases, HL is the first finding leading to a diagnosis of CLL that co-exists simultaneously. Here we report a 60 years old male patient who presented with an outside diagnosis of lymphocyte-rich classical HL. On evaluation, he had only B-symptoms in the form of low-grade fever and weight loss. Peripheral smear revealed mild leukocytosis with an absolute lymphocytosis and a few smudge cells. Bone marrow (BM) aspirate and biopsy exhibited diffuse infiltration by a small cell, low grade, Non-Hodgkin’s lymphoma with no immunohistochemical evidence of HL. Flow cytometry performed on BM was consistent with classical immunoprofile of CLL. Meanwhile the lymph node received for review revealed diffuse effacement of nodal architecture by small mature lymphocytes with immunoprofile of CLL expressing CD20, CD5, and CD23. Interspersed between these cells, were a few eosinophils along with classical Reed Sternberg cells, expressing CD30, MUM-1, CD15, and dim PAX-5, with a surrounding rosette of T-Cells highlighted by CD3 and PD-1 and negative for CD45, CD20, and EBV immunohistochemistry. Fluorodeoxyglucose positron emission tomography (FDG-PET) scan revealed hepatosplenomegaly with multiple supra/infra diaphragmatic lymph nodes. So, a final diagnosis of HL-RT in CLL was considered. The patient is currently doing well after the first cycle of ABVD chemotherapy. HL-RT occurring in CLL is a rare event with heterogeneous clinical presentation, morphology, clonal origin, disease course, prognostic features, and survival. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|