Abstract
Composite lymphoma (CL) is composed of 2 or more morphologically and immunophenotypically distinct lymphomas in a single anatomical site. Here we report a unique CL of the upper respiratory tract in an elderly male patient. Morphologically, the lymphoma was composed of 2 distinct and well-demarcated areas consisting of monotonous small to medium-sized lymphocytes and sheets of mature-appearing plasma cells. Immunophenotyping by both flow cytometry and immunohistochemistry revealed that the small to medium-sized lymphocytes were composed of 2 distinct subpopulations sharing a CD5+/CD19+/CD20+/CD22+/CD23-/FMC-7(+)/cyclin D1(+) immunophenotype but with different immunoglobulin (Ig) light and heavy chain expression, consistent with 2 immunophenotypically distinct mantle cell lymphomas (MCLs); the plasma cells were composed of CD38(bright +)/CD138+/IgG κ-restricted plasma cells, consistent with a plasmacytoma. Fluorescence in situ hybridization showed the t(11;14) translocation present in the lymphocyte region but absent in the plasma cell area. Ig heavy chain gene rearrangement studies on manually dissected populations showed 2 distinct patterns for the MCL and plasmacytoma. To our knowledge, this is the first report of a 3-way CL consisting of 2 immunophenotypically distinct MCLs and a plasmacytoma.
Original language | English (US) |
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Pages (from-to) | 781-787 |
Number of pages | 7 |
Journal | Human pathology |
Volume | 39 |
Issue number | 5 |
DOIs | |
State | Published - May 2008 |
Bibliographical note
Copyright:Copyright 2008 Elsevier B.V., All rights reserved.
Keywords
- Composite lymphoma
- Flow cytometry
- Fluorescence in situ hybridization (FISH)
- Mantle cell lymphoma
- Plasmacytoma
- Polymerase chain reaction (PCR)