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Histiocyte-rich B-cell lymphoma

T Sun¹, M Susin, F A Tomao

¹VA Medical Center, and Department of Pathology, University of Colorado School of Medicine, Denver 80220, USA.

Human Pathology

|December 31, 1997

Summary

This study details a rare histiocyte-rich B-cell lymphoma, analyzed using flow cytometry and cytogenetics. The findings highlight its aggressive nature and potential for misdiagnosis, emphasizing the need for accurate identification.

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Area of Science:

Hematology
Oncology
Immunology

Background:

Histiocyte-rich B-cell lymphoma (HRBCL) is a rare lymphoid neoplasm.
This report presents the second documented case of HRBCL and the first with comprehensive flow cytometry and cytogenetic analysis.

Observation:

Flow cytometry revealed a B-cell lymphoma phenotype with a significant population (79%) of CD11c positive histiocytes.
Immunohistochemistry confirmed abundant histiocytes (CD68, lysozyme positive) and neoplastic B-cells (CD20, CD45, CD74, CDw75 positive).
Cytogenetic analysis identified complex clonal abnormalities, including t(8;14)(q11;q32), and gene rearrangements confirmed B-cell monoclonality.

Findings:

The neoplastic lymphoid cells were large and pleomorphic, distinct from Hodgkin's disease L/H cells.

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The case exhibited a rapidly progressive clinical course, consistent with aggressive lymphoma behavior.

The prominent histiocytic component is hypothesized to be recruited by tumor-derived growth factors, contributing to proliferation and aggressiveness.

Implications:

Accurate diagnosis is crucial due to the potential for misdiagnosis as true histiocytic lymphoma.
This entity is associated with a predictable poor prognosis, necessitating specialized recognition.
Understanding the interplay between neoplastic B-cells and reactive histiocytes may offer therapeutic insights.