Angioimmunoblastic T-cell lymphoma (AITL) is a common subtype of peripheral T-cell lymphoma with an aggressive clinical course and poor prognosis after conventional chemotherapy, for which there is no current standard of care. We describe here an 87-year-old woman with AITL, whose clinical diagnosis was complicated by the presence of B immunoblasts positive for Epstein–Barr virus in the lymph nodes and monoclonal plasma cells in the bone marrow at initial presentation. Rebiopsy of the lymph node led to the correct diagnosis of AITL with concurrent smoldering plasma cell myeloma. She was treated with several courses of conventional chemotherapy, resulting in progressive disease, and then switched to the immunomodulatory drug lenalidomide, which used in Japan for the treatment of multiple myeloma. Lenalidomide was effective in controlling both AITL and plasma cell myeloma.
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We thank Mr. Masahiro Hirata and Mr. Hiroyuki Shirahase, Department of Diagnostic Pathology, Kyoto University Hospital, for their technical assistance.
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Figure S1 Multiplex PCR assessment of clonal IgH gene rearrangement using DNA extracted from the lymph node biopsied before treatment and from the bone marrow. In both samples, clonal peaks were detected (arrow heads) by capillary electrophoresis of the PCR products amplified with IgH VH (FR1, FR2, and FR3)-JH primer sets. DLBCL, diffuse large B-cell lymphoma; PCM, plasma cell myeloma (PDF 6792 KB)
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Kishimoto, W., Takiuchi, Y., Nakae, Y. et al. A case of AITL complicated by EBV-positive B cell and monoclonal plasma cell proliferation and effectively treated with lenalidomide. Int J Hematol 109, 499–504 (2019). https://doi.org/10.1007/s12185-018-02587-6
- Angioimmunoblastic T-cell lymphoma
- Peripheral T-cell lymphoma
- Plasma cell myeloma