Relationship between immunophenotype and the development of second primary neoplasms in patients with non-Hodgkin's...

We reviewed the records of 107 patients with non-Hodgkin's lymphoma (NHL) to evaluate the relation between second primary neoplasms and the NHL immunophenotype. The incidence of second primary neoplasms was 3.7%. There were one case of hepatocellular carcinoma and 3 cases of gastric adenocarcinoma including one patient who had a history of metachronous malignant lymphomas. Three patients had B cell lymphoma with monoclonal IgM kappa phenotype, and one patient had follicular mixed cell type lymphoma with serum monoclonal IgM kappa. The dominant immunophenotype of B cell lymphomas in Japanese patients is IgM lambda. We believe that the association of the uncommon phenotype of IgM kappa with second primary neoplasms, especially gastric cancer, reflects an underlying genetic predisposition. NHL patients with IgM kappa phenotype should be evaluated carefully for second primary neoplasms.