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Pathological and molecular analysis of a composite lymphoma of mantle cell lymphoma and Epstein–Barr virus-positive follicular lymphoma

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Abstract

Composite lymphoma (CL) is a very rare clinical entity defined by the presence of two or more different subtypes of lymphoma in the same lymph node. We report a case of CL in a 78-year-old male presenting with leukocytosis and swelling of multiple lymph nodes. A left axillary node biopsy showed atypical lymphocytes in both the interfollicular and follicular areas. Immunohistochemistry revealed that mantle cell lymphoma (MCL) was mainly present in the interfollicular area and follicular lymphoma (FL) was present in the follicular area. Polymerase chain reaction analysis of immunoglobulin heavy chain gene rearrangements confirmed that they were clonally related neoplasms. However, Epstein–Barr virus (EBV) DNA was detected in only FL cells, suggesting that MCL and FL had split into two clones in the early steps of pathogenesis. This is the first reported case of CL with EBV-negative B-cell non-Hodgkin lymphoma (NHL) and EBV-positive B-cell NHL with a clonal relationship. We discuss the developmental processes of these two lymphomas.

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Authors and Affiliations

  1. Department of Hematology, Gunma University Graduate School, 15-39-3 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Yuri Miyazawa, Takuma Ishizaki & Hiroshi Handa

  2. Department of Blood Transfusion, Gunma University Hospital, Gunma, Japan

    Akihiko Yokohama

  3. Department of Oncology Center, Gunma University Hospital, Maebashi, Gunma, Japan

    Norifumi Tsukamoto

  4. Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Gunma, Japan

    Hiromi Koshi

  5. Department of Pathology, Public Tomioka General Hospital, Tomioka, Japan

    Junko Hirato

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  1. Yuri Miyazawa
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  2. Akihiko Yokohama
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  3. Takuma Ishizaki
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  4. Norifumi Tsukamoto
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  5. Hiromi Koshi
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  6. Junko Hirato
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  7. Hiroshi Handa
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Correspondence to Yuri Miyazawa.

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Conflicts of interest

Norifumi Tsukamoto and Hiroshi Handa received honoraria from Kyowa Kirin, Chugai, Takeda, and Daiichi-Sankyo. Norifumi Tsukamoto received honoraria from Eisai, Pfizer, MSD, Teijin, and Astellas. Hiroshi Handa received honoraria from Celgene, Ono, Janssen, and Bayer.

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Miyazawa, Y., Yokohama, A., Ishizaki, T. et al. Pathological and molecular analysis of a composite lymphoma of mantle cell lymphoma and Epstein–Barr virus-positive follicular lymphoma. Int J Hematol 113, 592–599 (2021). https://doi.org/10.1007/s12185-020-03035-0

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  • DOI: https://doi.org/10.1007/s12185-020-03035-0

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