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Updated: Feb 10, 2026

Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
07:52

Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma

Published on: January 9, 2019

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High-grade B-cell lymphoma with MYC and BCL2 rearrangements arising in a composite lymphoma

Alison M Moore1, Olga Moshkin2, Gordon J Swain2

  • 1Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada.

Diagnostic Pathology
|May 26, 2018
PubMed

Insights

This study details a rare composite lymphoma with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), follicular lymphoma (FL), and high-grade B-cell lymphoma. Molecular analysis revealed a clonal link between FL and high-grade lymphoma, suggesting FL transformation into high-grade lymphoma.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Reports the first case of composite lymphoma involving chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), follicular lymphoma (FL), and high-grade B-cell lymphoma.
  • Highlights the co-occurrence of these distinct lymphoma subtypes within a single needle biopsy specimen.

Observation:

  • An 85-year-old male presented with cervical and inguinal masses.
  • Needle biopsy revealed morphologically, immunophenotypically, and topographically distinct CLL/SLL, FL, and high-grade B-cell lymphoma components.
  • Fluorescence in situ hybridization (FISH) detected IGH-BCL2 rearrangement in FL and high-grade B-cell lymphoma, and MYC rearrangement exclusively in high-grade B-cell lymphoma.

Findings:

  • Demonstrates a clonal relationship between FL and high-grade B-cell lymphoma components through molecular cytogenetics.
  • Suggests that high-grade lymphoma evolved from FL via transformation, acquiring MYC translocation.
  • No clonal relationship was evident between FL and CLL/SLL components, as IGH-BCL2 rearrangement was absent in CLL/SLL.

Implications:

  • Contributes to understanding clonal evolution in composite lymphomas.
  • Suggests a potential pathway for high-grade lymphoma development from pre-existing follicular lymphoma.
  • Underscores the importance of molecular techniques in elucidating complex lymphoproliferative disorders.
Abstract

Keywords:
BCL2Chronic lymphocytic leukemiaComposite lymphomaCytogeneticsDiffuse large B-cell lymphomaDouble-hit lymphomaFollicular lymphomaHigh-grade B-cell lymphomaMYCSmall lymphocytic lymphoma

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