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Case Reports
. 2016 Jul-Sep;20(3):241-243.

Extranodal marginal zone B-cell lymphoma arising in chronic myeloid leukaemia successfully treated with tyrosine kinase inhibitor: a case report

G Mihaylov  1 , V Varbanova  1 , V Stoeva  1 , T Dikov  2
Affiliations
Case Reports

Extranodal marginal zone B-cell lymphoma arising in chronic myeloid leukaemia successfully treated with tyrosine kinase inhibitor: a case report

G Mihaylov et al. Hippokratia. 2016 Jul-Sep.

Abstract

Background: Chronic myelogenous leukemia (CML) is a hematological malignancy that originates in an abnormal pluripotent bone marrow stem cell. CML is consistently associated with the expression of the BCR-ABL1 fusion gene, generated by the t(9;22) chromosomal translocation, thus creating the Philadelphia chromosome, a target for protein tyrosine kinase inhibitor (TKI) therapy. There is no published data, demonstrating increased risk for development of second cancers, associated with the exposure to TKIs.

Case report: We report a case of a primary extranodal marginal zone B-cell lymphoma (EMZBCL), diagnosed in a 53-year-old woman with CML receiving treatment with TKI the preceding seven years. Both diagnoses were confirmed by cytological/histological examination. Regarding CML, complete hematological, cytogenetic, and molecular remission was achieved by imatinib therapy. Regarding EMZBCL complete remission with an anthracycline-based polychemotherapy was achieved, while the patient was on continuous treatment with imatinib. Currently, the patient is in major molecular response for CML (151 months) and also in complete remission for EMZBCL (60 months).

Conclusion: We report this case as we consider that any secondary neoplasia developing in patients treated with TKIs should be reported for assessment and further detailed analyzes. Hippokratia 2016, 20(3): 241-243.

Keywords: Extranodal marginal zone B-cell lymphoma; chronic myeloid leukemia; tyrosine kinase inhibitor.

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Figures

Figure 1
Figure 1. Morphological diagnosis of extranodal marginal zone lymphoma (EMZL): nodular and diffuse infiltrates obscure the normal glandular structure, most neoplastic lymphocytes being small to medium size with moderate amount of clear cytoplasm - so called monocytiod appearance. Further, clear evidence of aggressive behavior is seen in the well-formed lympho-epithelial lesions (hematoxylin-eosin, original magnification ×40).
Figure 2
Figure 2. Lymphomatous cells show a strong positivity for CD20 immunostaining (CD20 immunostain, original magnification x20).
See this image and copyright information in PMC

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