Parosteal lymphoblastic lymphoma. A human counterpart of Abelson virus-induced lymphosarcoma of mice

A 16-year-old girl with an unusual presentation of lymphoblastic lymphoma is described. The tumor originated as a paraspinal mass accompanied by lytic bone lesions in the pelvic bones. Neither an anterior mediastinal mass nor lymphadenopathy were noted. This pattern of disease is strikingly reminiscent of lymphomas induced in mice by the Abelson leukemia virus. This patient's lymphoma cells, unlike the usual lymphoblastic lymphoma cells, did not bear classical T-lymphocyte surface markers. A permanent cell line was derived from her tumor. Sparse amounts of cytoplasmic mu-immunoglobulin heavy chains were present in most of these cells, suggesting that the tumor originated in pre-B-lymphocytes. The phenotype of the cultured tumor cells is similar to Abelson virus-transformed murine bone marrow cells. Tumor cells of this phenotype may originate in the bone marrow and spread subsequently in and around the involved bones. This pattern of disease is distinctly different from that of T-cell lymphoblastic lymphoma, which typically presents in the mediastinum and cervical lymph nodes, and involves the bone marrow only as a late manifestation of advanced disease.