Aggressive B-cell lymphoma with dual surface immunoglobulin light-chain expression

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Dual surface immunoglobulin light-chain expression is a rare event in B-cell neoplasms, primarily documented in chronic lymphocytic leukemia.
• Understanding aberrant B-cell immunophenotypes is crucial for accurate diagnosis and treatment strategies in lymphoid malignancies.

Observation:

• A 69-year-old woman presented with aggressive B-cell lymphoma.
• Flow cytometry revealed lymphoma cells positive for CD5, CD19, CD20, HLA-DR, and importantly, both kappa and lambda light chains.
• Southern blot analysis confirmed monoclonal heavy chain rearrangement alongside rearranged bands for both kappa and lambda light chains.

Findings:

• This case represents the first documented instance of aggressive B-cell lymphoma with dual kappa/lambda surface immunoglobulin light-chain expression.
• The patient received treatment with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) but experienced disease progression.

Implications:

• This case expands the spectrum of B-cell malignancies exhibiting dual light-chain expression.
• Further research into the underlying mechanisms of aberrant light-chain expression in aggressive B-cell lymphomas is warranted.
• Investigating such rare immunophenotypic anomalies may offer insights into B-cell differentiation and oncogenesis.