Related Experiment Video
Updated: Jun 3, 2026
Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
Published on: September 7, 2022
CD30-positive EBV-associated diffuse large B-cell lymphoma occurring after immunosuppressive therapy for T-cell
Ahmad Alduaij1, Diana O Treaba, Eric S Winer
1Department of Pathology, the Warren albert Medical School at Brown University, Rhode Island Hospital, Providence, RI 02908, USA. dralduaij@gmail.com
Insights
A patient developed diffuse large B-cell lymphoma (DLBCL) shortly after T-cell prolymphocytic leukemia (T-PLL) treatment. This case highlights the potential for secondary malignancies following leukemia therapy.
Area of Science:
- Hematology
- Oncology
Background:
- T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive lymphoid malignancy.
- Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma.
Observation:
- A 64-year-old male was diagnosed with T-PLL characterized by a high white blood cell count and circulating prolymphocytes.
- The patient exhibited T-cell receptor gene rearrangements and underwent chemotherapy without achieving complete remission.
- Nine months later, a new inguinal mass was detected and diagnosed as CD30-positive, Epstein-Barr Virus (EBV)-associated DLBCL.
Findings:
- The case presents a rare instance of secondary DLBCL developing subsequent to T-PLL diagnosis and treatment.
- Immunophenotypic analysis of T-PLL cells showed characteristic T-cell markers, while the DLBCL was CD30-positive and EBV-associated.
- Incomplete cytogenetic remission after T-PLL treatment may have been a contributing factor.
Implications:
- This case underscores the importance of monitoring patients with T-PLL for the development of secondary hematologic malignancies.
- Further research is needed to understand the potential link between T-PLL and the subsequent development of DLBCL.
- Investigating the role of prior chemotherapy and EBV in the pathogenesis of secondary DLBCL is crucial.
Abstract:
We describe the case of a 64-year-old man who developed diffuse large B-cell lymphoma (DLBCL) in less than a year after he was diagnosed and treated for T-cell prolymphocytic leukemia (T-PLL). At the time of diagnosis of T-PLL he had a white blood cell count (WBC) of 38.2×10(9)/L and only few small lymph nodes were identified on physical examination. Hepatosplenomegaly or skin lesions were not present. Peripheral blood examination was remarkable for 91% circulating prolymphocytes, which by flow cytometry immunophenotypic analysis were CD2, CD3, CD5, and CD7 positive and coexpressed CD4 and CD8 (absolute number, 33.4×10(9)/L). T-cell receptor (TCR) β and γ genes rearrangements were identified by polymerase chain reaction (PCR). The patient underwent chemotherapy, but did not completely achieve cytogenetic remission. Nine months after his diagnosis of T-PLL, he underwent surgical excision of a new 7 cm left inguinal mass, and was diagnosed with CD30 positive Epstein-Barr Virus (EBV)-associated DLBCL.
