Lymphoblastic lymphoma with a triple-hit profile: a rare but distinct and relevant entity

Hum Pathol. 2017 May:63:171-176. doi: 10.1016/j.humpath.2016.11.002. Epub 2016 Nov 17.

Abstract

Follicular lymphoma with progression to a high-grade lymphoma bears a poor prognosis. We describe a case of a 60-year-old man who presented in 2012 with an epidural mass, diagnosed as a diffuse large B-cell lymphoma (DLBCL) with concurrent low-grade follicular lymphoma. Three years later, the patient presented with a cervical mass, diagnosed as a lymphoblastic lymphoma (LBL). Both the DLBCL and LBL contained a "triple hit" with BCL2, BCL6, and cMYC translocations demonstrated by fluorescence in situ hybridization analysis and a complex karyotype by single-nucleotide polymorphism array analysis. Furthermore, the 2 lymphomas were shown to be clonally related by clonality analysis and single-nucleotide polymorphism array analysis. This case report presents a highly unusual case of an LBL with a triple hit, originating from a DLBCL, which has rarely been described in the literature and deserves further exploration.

Keywords: Complex karyotype; Lymphoblastic lymphoma; SNP array; Transformation; Triple hit.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics*
  • Flow Cytometry
  • Gene Expression Profiling / methods
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Karyotype
  • Karyotyping
  • Lymphoma, Follicular / chemistry
  • Lymphoma, Follicular / genetics*
  • Lymphoma, Follicular / pathology
  • Lymphoma, Follicular / therapy
  • Lymphoma, Large B-Cell, Diffuse / chemistry
  • Lymphoma, Large B-Cell, Diffuse / genetics*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Male
  • Middle Aged
  • Oligonucleotide Array Sequence Analysis
  • Polymorphism, Single Nucleotide*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy

Substances

  • Biomarkers, Tumor