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


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.

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L. Rajappannair, E. Lam, D. Benson, F. Racke, S. Devine and W. Zhao, "Collision Anaplastic Large Cell Lymphoma (T-Cell/Histiocyte-Rich) and Diffuse Large B Cell Lymphoma: A Pathologic and Clinical Evaluation," Journal of Cancer Therapy, Vol. 3 No. 6, 2012, pp. 1060-1065. doi: 10.4236/jct.2012.36138.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] K. J. Cheung, W. Tam, E. Chuang and M. P. Osborne, “Concurrent Invasive Ductal Carcinoma and Chronic Lymphocytic Leukemia Manifesting as a Collision Tumor in Breast,” The Breast Journal, Vol. 13, No. 4, 2007, pp. 413-417.
[2] O. Kawashima, S. Sakata, M. Kamiyoshihara, A. Maeshima, S. Ishikawa and Y. Morishita, “Primary Pul-monary Collision Tumor Including Squamous Cell Car-cinoma and T-Cell Lymphoma,” Lung Cancer, Vol. 23, No. 1, 1999, pp. 67-70.
[3] A. S. Allal, J. Weintraub, S. Remadi and R. Abele, “Concurrent Interfollicular Hodgkin’s Disease and Metastatic Breast Carcinoma in Lymph Nodes,” Pathology International, Vol. 46, No. 10, 1996, pp. 787-790.
[4] M. O. Lovell and P. T. Valente, “Unique Collision of Hodgkin Lymphoma and Adenosquamous Carcinoma in the Uterine Cervix: Synchronous Malignant Neo Plasms of the Cervix,” Journal of Lower Genital Tract Disease, Vol. 7, No. 4, 2003, pp. 307-310.
[5] M. Tunc, M. L. Simmons, D. H. Char and B. Herndier, “Non-Hodgkin Lymphoma and Kaposi Sarcoma in an Eyelid of a Patient with Acquired Immunodeficiency Syndrome. Multiple Viruses in Pathogenesis,” Archives of Ophthalmology, Vol. 115, No. 11, 1997, pp. 1464-1466.
[6] T. Isaka, T. Nakamura and M. Tajika, “API2-MALT1 Chimeric Transcript-Positive Gastroduodenal MALT Lymphoma with Subsequent Development of Adenocarcinoma as a Collision Tumour over a Clinical Course of 7 Years,” Histopathology, Vol. 51, No. 1, 2007, pp. 119-123.
[7] G. Cammarota, L. M. Larocca, D. D’Ugo, R. Persiani, R. Cianci, R. Nocente, A. Picciocchi and G. Gasbarrini, “Synchronous Gastric Adenocarcinoma and MALT Lymphoma in a Patient with H. Pylori Infection. Could the Two Neoplasms Share a Common Pathogenesis?” Hepato-Gastroenterology, Vol. 48, No. 37, 2001, pp. 104-106.
[8] A. C. Wotherspoon and P. G. Isaacson, “Synchronous Adenocarcinoma and Low Grade B-Cell Lymphoma of Mucosa Associated Lymphoid Tissue (MALT) of the Stomach,” Histopathology, Vol. 27, No. 4, 1995, pp. 325-331.
[9] B. Susnik, J. Jordi Rowe, P. N. Redlich, C. Chitambar, C. C. Chang and B. Kampalath, “A Unique Collision Tumor in Breast: Invasive Ductal Carcinoma and Mucosa-Associated Lympoid Tissue Lymphoma,” Archives of Pathology & Laboratory Medicine, Vol. 128, No. 1, 2004, pp. 99-101.
[10] A. A. Abou-Elella and T. P. Nifong, “Composite EBV Negative Peripheral T-Cell Lymphoma and Diffuse Large B-Cell Lymphoma Involving the Ileum: A Case Report and a Systematic Review of the Literature,” Leukemia & Lymphoma, Vol. 47, No. 10, 2006, pp. 2208-2217.
[11] A. van den Berg, E. Maggio, R. Rust, R. Rust, K. Kooistra, A. Diepstra and S. Poppema, “Clonal Relation in a Case of CLL, ALCL, and Hodgkin Composite Lymphoma,” Blood, Vol. 100, No. 4, 2002, pp. 1425-1429.
[12] Y. Xu, R. W. Mckenna, M. P. Hoang, R. H. Collins and S. H. Kroft, “Composite Angioimmunoblastic T-Cell Lymphoma and Diffuse Large B-Cell Lymphoma: A Case Report and Review of the Literature,” American Journal of Clinical Pathology, Vol. 118, No. 6, 2002, pp. 848-854.
[13] B. Christian, W. Zhao, M. Hamadani, E. M. Sotomayor, W. Navarro, S. M. Devine, F. Racke and K. A. Blum, “Mantle Cell Lymphoma 12 Years after Allogeneic Bone Marrow Transplantation Occurring Simultaneously in Recipient and Donor,” Journal of Clinical Oncology, Vol. 28, No. 31, 2010, pp. e629-e632. doi:10.1200/JCO.2010.29.8992
[14] E. Haralambieva, K. A. Pulford, L. Lamant, S. Pileri, G. Roncador, K. C. Gatter, G. Delsol and D. Y. Mason, “Anaplastic Large-Cell Lymphomas of B-Cell Phenotype Are Anaplasticlymphoma Kinase (ALK) Negative and belong to the Spectrum of Diffuse Large B-Celllymphomas,” British Journal of Haematology, Vol. 109, No. 3, 2000, pp. 584-591. doi:10.1046/j.1365-2141.2000.02045.x
[15] P. Adam, T. Katzenberger, H. Seeberger, S. Gattenlohner, J. Wolf, C. Steinlein, M. Schmid, H. K. Müller-Hermelink and G. Ott, “A Case of a Diffuse Large B-Cell Lymphoma of Plasma Blastic Type Associated with the t(2;5)(p23;q35) Chromosome Translocation,” American Journal of Surgical Pathology, Vol. 27, No. 11, 2003, pp. 1473-1476. doi:10.1097/00000478-200311000-00012
[16] R. D. Gascoyne, L. Lamant, J. I. Martin-Subero, V. S. Lestou, N. L. Harris, H. K. Müller-Hermelink, J. F. Seymour, L. J. Campbell, D. E. Horsman, I. Auvigne, E. Espinos, R. Siebert and G. Delsol, “ALK-Positive Diffuse Large B-Cell Lymphoma Is Associated with ClathrinALK Rearrangements: Report of 6 Cases,” Blood, Vol. 102, No. 7, 2003, pp. 2568-2573. doi:10.1182/blood-2003-03-0786
[17] M. Herling, G. Z. Rassidakis, D. Jones, A. Schmitt-Graeff, A. H. Sarris and L. J. Medeiros, “Absence of Epstein-Barr Virus in Anaplastic Large Cell Lymphoma: A Study of 64 Cases Classified According to World Health Organization Criteria,” Human Pathology, Vol. 35, No. 4, 2004, pp. 455-459. doi:10.1016/j.humpath.2003.10.013

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