Collision Anaplastic Large Cell Lymphoma (T-Cell/Histiocyte-Rich) and Diffuse Large B Cell Lymphoma: A Pathologic and Clinical Evaluation

Lakshmi Rajappannair, Elaine Lam, Don Benson, Frederick Racke, Steven Devine, Weiqiang Zhao

Division of Hematology, The Department of Medicine, The Ohio State University Medical Center, Columbus, USA.
Division of Hematology, The Department of Medicine, The Ohio State University Medical Center, Columbus, USA..
Division of Hematopathology, Department of Pathology, The Ohio State University Medical Center, Columbus, USA.

DOI: 10.4236/jct.2012.36138                

Abstract

A collision tumor of T and B-cell lymphomas occur rarely. In this article we report a collision tumor of anaplastic large cell lymphoma and diffuse large B cell lymphoma in a 46 year old female. The tumor showed predominantly neoplastic anaplastic large cell lymphoma (ALCL) component expressing CD30 and ALK with smaller areas of CD20+ diffuse large B cell lymphoma component. Polymerase chain reaction for T-cell receptor beta and IgH (VDJ) gene rearrangements detected a clonal T cell and a clonal B cell population. The patient developed CSF involvement approximately 3 months after treatment. CSF analysis at this time showed only monoclonal T cells, probably due to clearing of the B cell component by the chemotherapy. To the best of our knowledge this is the first case report of a composite tumor of ALCL (lymphohistiocytic variant) and DLBCL. This case raises issues related to the classification of these composite lymphomas and the treatment on initial presentation and during relapse.

Keywords

Collision Lymphoma; ALCL; DLBCL

Conflicts of Interest

The authors declare no conflicts of interest.

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