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[Diffuse large B-cell lymphoma expressing surface immunoglobulin heavy chain (Ig alpha) and lacking light chains]
Miki Ando1, Yasushi Isobe, Makoto Sasaki
1Department of Hematology, Juntendo University School of Medicine.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|January 31, 2006
Summary
A woman with goiter was diagnosed with diffuse large B-cell lymphoma (DLBCL) affecting both stomach and thyroid. Successful treatment with chemotherapy and stem cell transplant led to long-term remission.
Area of Science:
- Oncology
- Hematology
- Immunology
Background:
- Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
- Extranodal involvement, such as in the thyroid, can complicate diagnosis and treatment.
- Understanding the immunophenotype and cytogenetics of DLBCL is crucial for targeted therapy.
Observation:
- A 59-year-old woman presented with symptoms including nausea, vomiting, and weight loss.
- Gastric biopsy confirmed diffuse large B-cell lymphoma (DLBCL).
- Thyroid biopsy revealed lymphoma infiltration positive for CD19, CD20, CD38, and HLA-DR, with aberrant light chain expression.
Findings:
- The patient's lymphoma cells expressed a heavy chain but lacked kappa and lambda light chains.
- Cytogenetic analysis identified complex chromosomal abnormalities: 47, XX, t(2;3)(q31;q13), +3, t(8;22)(q24;q11).
- The patient received five courses of CHOP chemotherapy followed by autologous peripheral blood stem cell transplantation.
Implications:
- This case highlights the importance of thorough investigation in patients with unexplained symptoms and extranodal masses.
- The aberrant immunophenotype and specific chromosomal translocations may influence treatment response and prognosis in DLBCL.
- Successful management with chemotherapy and autologous stem cell transplantation offers a potential curative option for extranodal DLBCL.