Related Experiment Videos
B-cell lymphoma associated with chronic lymphatic leukaemia: two cases with contrasting aggressive and indolent
R C Ratnavel1, D K Dunn-Walters, L Boursier
1Department of Dermatopathology, St John's Institute of Dermatology, United Medical and Dental Schools (UMDS), UMDS, London SE1 7EH, U.K. ratnavel@epulse.net
Abstract:
The term Richter's syndrome is used to describe the transformation of chronic lymphatic leukaemia (CLL) into a high-grade systemic lymphoma and is associated with a poor prognosis. We have undertaken detailed molecular studies in two patients with cutaneous B-cell lymphoma (CBCL) and CLL. Patient 1 exhibited a low-grade CBCL with different immunoglobulin gene rearrangements in blood and skin. By contrast, patient 2 showed identical gene rearrangements, confirmed by gene sequencing, and died within 4 months of presentation. The latter patient fulfilled the criteria for a diagnosis of cutaneous Richter's syndrome, whereas the former patient demonstrated the coincidence of CLL with a primary CBCL. Our results highlight the importance of gene rearrangement studies with sequencing for the accurate diagnosis of cutaneous Richter's syndrome.