論文

2021年5月26日

Case Report: Concurrent Occurrence of Abdominal Double Expressor Lymphoma and Jejunum Follicular Lymphoma

Frontiers in Oncology
  • Ryutaro Takada
  • Tomohiro Watanabe
  • Ikue Sekai
  • Keisuke Yoshikawa
  • Akane Hara
  • Yasuo Otsuka
  • Tomoe Yoshikawa
  • Ken Kamata
  • Kosuke Minaga
  • Yoriaki Komeda
  • Takaaki Chikugo
  • Yasuyuki Arai
  • Kohei Yamashita
  • Masatoshi Kudo
  • 全て表示

11
記述言語
掲載種別
研究論文(学術雑誌)
DOI
10.3389/fonc.2021.656219
出版者・発行元
Frontiers Media SA

Double expressor lymphoma (DEL), defined as overexpression of BCL2 and MYC, is an aggressive subtype of diffuse large B cell lymphoma (DLBCL). Here we report a case of a 64-year-old female diagnosed with abdominal DEL transformed from jejunum follicular lymphoma (FL). 18F-fluorodeoxyglucose (FDG)-positron emission tomography showed diffuse accumulation of FDG into the peritoneum and small bowel wall. Double balloon-assisted enteroscopy revealed whitish submucosal tumors in the proximal jejunum. Aggregation of atypical lymphocytes positive for CD20, CD79a, and BCL2 was seen in the jejunal biopsy samples. These atypical lymphocytes were monoclonal since cell surface expression of Ig light chains was limited to κ chain by flow-cytometry. Thus, immunohistochemical and flowcytometric analyses data were consistent with FL of the jejunum. Neoplastic lymphocytes obtained from ascites were positive for CD10, CD20, CD79a, BCL2, and BCL6. Fluorescence <italic>in situ</italic> hybridization (FISH) showed formation of <italic>BCL2/IgH</italic> fusion gene and extra copies of <italic>MYC</italic>, the former of which is a characteristic chromosomal abnormality of FL. These genetic alterations and protein expression profiles of ascitic fluid cells were consistent with those of DEL transformed from FL. Given that a significant population of patients with indolent FL of the gastrointestinal tract developed into aggressive DLBCL, it is likely that primary FL of the jejunum transformed into the abdominal aggressive DEL in this case. This case is unique in that concurrent occurrence of FL and DEL was confirmed by immunohistochemical and FISH analyses and that abdominal DEL transformed from jejunal FL was highly suspected.

リンク情報
DOI
https://doi.org/10.3389/fonc.2021.656219
URL
https://www.frontiersin.org/articles/10.3389/fonc.2021.656219/full
ID情報
  • DOI : 10.3389/fonc.2021.656219
  • eISSN : 2234-943X

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