Genotypic and immunohistological demonstration of the progression of an unusual reactive-like B-cell lymphoproliferative disorder to a high grade diffuse lymphoma

Riccardo Dolcetti, Valli De Re, Antonino Carbone, Salvatore De Vita, Annunziata Gloghini, Umberto Tirelli, Bruno Pasquotti, Mauro Boiocchi

Research output: Contribution to journalArticlepeer-review

Abstract

In the present study the clinical and pathological evolution of a reactive-like B-cell lymphoproliferative disorder with an unusually high content of T cells is described. Immunogenotypic analysis showed that the same phenotypically atypical B-cell clone, characterized by the unusual presence of an immunoglobulin (Ig)K gene rearrangement, with the heavy chain (IgH) gene in germline configuration, was invariantly present in all phases of the disease. The disorder showed an indolent course for a long period of time during which the clonal B-cell population coexisted with an abundant, reactive T-cell component in different locations of the disease. These findings, together with the observation of spontaneous progression and regression phases of the disorder and its responsiveness to corticosteroids, suggest that functional interactions between the B-cell clone and the polyclonal infiltrating T cells probably were involved in the pathogenesis of the disease. After the administration of the antiblastic treatment, a progressive reduction of the reactive T-cell component was observed with the concomitant evolution to a diffuse large cell (immunoblastic) B-cell lymphoma and the appearance of an IgH gene rearrangement. The biological characteristics and the clinical evolution of the case described here are similar to those reported for the so-called "T-cell-rich B-cell lymphomas" (TCRBCLs). These findings suggest that the Tcell-rich pattern may identify a group of B-cell lymphoproliferations with common pathogenetic mechanisms and clinical behavior.

Original languageEnglish
Pages (from-to)348-354
Number of pages7
JournalHuman Pathology
Volume26
Issue number3
DOIs
Publication statusPublished - 1995

Keywords

  • immunoglobulin gene rearrangement
  • in situ immunophenotyping
  • reactive T cells
  • T-cell-rich B-cell lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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