Abstract
Histiocytic/dendritic cell sarcomas arising from follicular lymphoma are very rare and poorly understood lesions. We describe a case, which is unique in that it presented with a hipbone lesion simultaneously with axillary lymphadenopathy. Biopsy of the axillary lymph node showed a low-grade follicular lymphoma. The hipbone lesion was comprised two cell populations, one representing diffuse large B cell lymphoma and the other a histiocytic/dendritic sarcoma. The cells of all three lesions contained an IGH/BCL2 rearrangement, suggesting that both diffuse large B cell lymphoma and histiocytic/dendritic sarcoma differentiation developed from the same low grade precursor (follicular lymphoma). This case illustrates that sarcomatous transdifferentiation of follicular lymphoma can be an unpredictable local phenomenon and that it can occur extra nodally in the bone marrow. It may also occur concurrently with the progression of follicular lymphoma to a diffuse large B cell lymphoma.
Similar content being viewed by others
References
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of tumour of haematopoietic and lymphoid tissue. 4th ed. Lyon: International Agency for Research on Cancer (IARC); 2008.
Haarer CF, Roberts RA, Gromas TM, Rimsza LM. Immunohistochemical classification of De Novo, transformed and relapsed diffuse large B-cell lymphoma into germinal center B cell and non germinal center B-cell subtypes correlates with gene expression profile and patient survival. Arch Pathol Lab Med. 2006;130:1819–24.
Christie L, Kermohan N, Levison D, et al. cMYC translocation in t(14;18) positive follicular lymphoma at presentation: an adverse prognostic indicator? Leuk Lymphoma. 2008;49:470–6. doi:10.1080/10428190701836845.
Vasef MA, Zaatari GS, Chan WC, Sun NC, Weiss LM, Brynes RK. Dendritic cell tumors associated with low-grade B-cell malignancies: report of three cases. Am J Clin Pathol. 1995;104:696–701.
Cossu A, Deiana A, Lissia A, et al. Synchronous interdigitating dendritic cell sarcoma and B-cell small lymphocytic lymphoma in a lymph node. Arch Pathol Lab Med. 2006;130:544–7.
Gaertner EM, Tsokos M, Derringer GA, Neuhauser TS, Arciero C, Andriko JA. Interdigitating dendritic cell sarcoma: a report of four cases and review of the literature. Am J Clin Pathol. 2001;115:589–97. doi:10.1309/M95G-7DQ2-TLQL-7Q11.
Wetzler M, Kurzrock R, Goodacre AM, McLaughlin P, Ku S, Talpaz M. Transformation of chronic lymphocytic leukemia to lymphoma of true histiocytic type. Cancer. 1995;76:609–17. doi:10.1002/1097-0142(19950815)76:4<609::AID-CNCR2820760411>3.0.CO;2-Y.
Alvaro T, Bosch R, Salvado MT, Piris MA. True histiocytic lymphoma of the stomach associated with low-grade B-cell mucosa-associated lymphoid tissue (MALT)-type lymphoma. Am J Surg Pathol. 1996;20:1406–11. doi:10.1097/00000478-199611000-00013.
Feldman AL, Minniti C, Santi M, Downing JR, Raffeld M, Jaffe ES. Histiocytic sarcoma after acute lymphoblastic leukaemia: a common clonal origin. Lancet Oncol. 2004;5:248–50. doi:10.1016/S1470-2045(04)01428-7.
Magni M, Di Nicola M, Carlo-Stella C, et al. Identical rearrangement of immunoglobulin heavy chain gene in neoplastic Langerhans cells and B-lymphocytes: evidence for a common precursor. Leuk Res. 2002;26:1131–3. doi:10.1016/S0145-2126(02)00009-7.
Feldman AL, Arber DA, Pittaluga S, et al. Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: evidence for transdifferentiation of the follicular lymphoma clone. Blood. 2008;111:5433–8. doi:10.1182/blood-2007-11-124792.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Zhang, D., McGuirk, J., Ganguly, S. et al. Histiocytic/dendritic cell sarcoma arising from follicular lymphoma involving the bone: a case report and review of literature. Int J Hematol 89, 529–532 (2009). https://doi.org/10.1007/s12185-009-0300-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-009-0300-y