Synchronous interdigitating dendritic cell sarcoma and B-cell small lymphocytic lymphoma in a lymph node

Institutes of Anatomic Pathology and Histopathology, University of Sassari, Sassari, Italy.
Archives of pathology & laboratory medicine (Impact Factor: 2.84). 05/2006; 130(4):544-7. DOI: 10.1043/1543-2165(2006)130[544:SIDCSA]2.0.CO;2
Source: PubMed

ABSTRACT A gradually enlarging axillary mass in a 79-year-old man was excised. The specimen was processed for light microscopy, immunohistochemical studies, and electron microscopy; gene rearrangement studies were also performed. A diagnosis of an interdigitating dendritic cell tumor of the lymph node and a B-cell small lymphocytic lymphoma occurring in the same anatomic location was made. We found that although rare cases of interdigitating dendritic cell tumor with an associated secondary malignancy have been described in the literature, to our knowledge, this is the first report of interdigitating dendritic cell tumor and synchronous neoplasm diagnosed at the same site. A possible relationship between the 2 disorders is also discussed.

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Available from: Antonio Cossu, Sep 27, 2015
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    • "However, recent studies have shown that histiocytic/dendritic cell sarcomas and some lymphoproliferative diseases, such as follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and hairy cell leukemia, may occur in the same individual and interestingly, these neoplasms are clonally related. This phenomenon is dubbed “transdifferentiation”.[12345678] There have been several reports showing synchronous IDCS and CLL/SLL; however, only one case of concurrent LCS and CLL/SLL has been documented in the English literature.[9] "
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    ABSTRACT: Rare cases of histiocytic and dendritic cell (H/DC) neoplasms have been reported in patients with follicular lymphoma (FL), but the biologic relationship between the 2 neoplasms is unknown. We studied 8 patients with both FL and H/DC neoplasms using immunohistochemistry, fluorescence in situ hybridization (FISH) for t(14;18), and polymerase chain reaction (PCR)/sequencing of BCL2 and IGH rearrangements. There were 5 men and 3 women (median age, 59 years). All cases of FL were positive for t(14;18). The H/DC tumors included 7 histiocytic sarcomas, 5 of which showed evidence of dendritic differentiation, and 1 interdigitating cell sarcoma. Five H/DC tumors were metachronous, following FL by 2 months to 12 years; tumors were synchronous in 3. All 8 H/DC tumors showed presence of the t(14;18) either by FISH, or in 2 cases by PCR with the major breakpoint region (MBR) probe. PCR and sequencing identified identical IGH gene rearrangements or BCL2 gene breakpoints in all patients tested. All H/DC tumors lacked PAX5, and up-regulation of CEBPbeta and PU.1 was seen in all cases tested. These results provide evidence for a common clonal origin of FL and H/DC neoplasms when occurring in the same patient, and suggest that lineage plasticity may occur in mature lymphoid neoplasms.
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