International Journal of Hematology

DOI: 10.1007/s12185-019-02591-4 Pages: 723-730

Follicular lymphoma suggested to transform into EBV-negative plasmablastic lymphoma

1. Gifu Prefectural General Medical Center, Department of Hematology

2. Gifu University Graduate School of Medicine, First Department of Internal Medicine

3. Matsunami General Hospital, Department of Hematology

4. Gifu Prefectural General Medical Center, Division of Pathology

Correspondence to:
Hisashi Tsurumi
Tel: +81-58-230-6308
Email: htsuru@gifu-u.ac.jp

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Abstract

Follicular lymphoma (FL) is an indolent lymphoma that often transforms into a high-grade lymphoma, mostly diffuse large B-cell lymphoma. A case of FL suggested to transform into plasmablastic lymphoma is presented. A 59-year-old man was admitted to our hospital because of right lower abdominal pain and vomiting. Computed tomography showed a mass in the ileocecum. Colonoscopy showed a mass with an ulcer in the ascending colon, and surgery was performed. Immunohistochemical staining of the biopsied mass showed infiltrated lymphocytes that were positive for CD38, CD45, CD138, and λ chain, and negative for CD4, CD5, CD8, CD10, CD20, CD56, and κ chain. Flow cytometric analysis of the ascites showed similar results. FISH analyses performed using lymph node biopsy specimens, ascite fluid and pleural effusion fluid identified the presence of an IGH/BCL2 translocation. FL was suggested to transform into PBL. Although the patient received three courses of R-CHOP chemotherapy and salvage chemotherapy, the patient died because of lymphoma progression less than 6 months after the diagnosis of PBL. Transformation of FL to PBL is highly unusual. The lack of a standard treatment for PBL results in the poor outcome of this entity. Novel therapeutic approaches are needed.

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