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

Summary 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, th...

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Bibliographic Details
Published in:	Human pathology 2017-05, Vol.63, p.171-176
Main Authors:	Hiemcke-Jiwa, Laura S., MD, Leguit, Roos J., MD, van der Veken, Lars T., PhD, Buijs, Arjan, PhD, Leeuwis, Jan Willem, MD, PhD, de Boer, Mirthe, MD, Jiwa, N. Mehdi, MD, PhD, Bloem, Andries C., PhD, Petersen, Eefke J., MD, PhD, de Weger, Roel A., PhD, Huibers, Manon M.H., PhD
Format:	Article
Language:	eng
Subjects:	Biomarkers, Tumor - analysis Biomarkers, Tumor - genetics Bone marrow Chromosomes Cloning Complex karyotype Deoxyribonucleic acid DNA Flow Cytometry Gene Expression Profiling - methods Humans Immunohistochemistry In Situ Hybridization, Fluorescence Karyotype Karyotyping Lymphoblastic lymphoma Lymphoma 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 Mutation Nervous system Oligonucleotide Array Sequence Analysis Pathology Patients 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 SNP array Tomography Transformation Triple hit
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Summary:	Summary 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 SNP-array analysis. Furthermore, the two lymphomas were shown to be clonally related by clonality analysis and SNP-array analysis. This case report presents a highly unusual case of a lymphoblastic lymphoma with a triple hit, originating from a DLBCL, which has rarely been described in literature and deserves further exploration.
ISSN:	0046-8177 1532-8392