Double- and triple-hit lymphomas can present with features suggestive of immaturity, including TdT expression, and create diagnostic challenges

Laura E Moench, Zohar Sachs, Garth Aasen, Michelle Dolan, Vanessa D Dayton, Elizabeth L Courville

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Double- and triple-hit lymphomas (DHL/THL) are aggressive B-cell neoplasms characterized by translocation of MYC with concurrent BCL2 and/or BCL6 translocation. In this retrospective study from one institution, we report clinicopathologic features of 13 cases (9 DHL/4 THL). The median age was 59 years (range 30–74) and patients included eight females and five males. Presentation included enlarging lymphadenopathy/masses (11 patients) and abnormal peripheral blood findings (2 patients). Features which raised the differential of an immature neoplasm included terminal deoxynucleotidyl transferase positivity (four cases, two THL/two DHL); dim CD45 expression (seven cases), lack of CD20 (two cases), or lack of surface immunoglobulin light chain (three cases) by flow cytometry; and blastoid morphology (two cases). We conclude that expression of TdT in a B-cell lymphoma with mature features or expression of surface light chain in a case otherwise suggestive of B-lymphoblastic leukemia/lymphoma should prompt an expedited evaluation for DHL/THL.

Original languageEnglish (US)
Pages (from-to)2626-2635
Number of pages10
JournalLeukemia and Lymphoma
Volume57
Issue number11
DOIs
StatePublished - Nov 1 2016

Bibliographical note

Publisher Copyright:
© 2016 Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • B lymphoblastic leukemia/lymphoma
  • B-cell lymphoma unclassifiable
  • diffuse large B-cell lymphoma
  • double-hit lymphoma
  • triple-hit lymphoma

Fingerprint

Dive into the research topics of 'Double- and triple-hit lymphomas can present with features suggestive of immaturity, including TdT expression, and create diagnostic challenges'. Together they form a unique fingerprint.

Cite this