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Case Reports
. 2018 Aug 2:2018:4312594.
doi: 10.1155/2018/4312594. eCollection 2018.

Composite t(14;18)-Negative Follicular Lymphoma and Nodular Lymphocyte-Predominant Hodgkin Lymphoma

John Patrick O'Neill  1 , Fiona Quinn  1 , Anita Dowling  1 , Jan Walker  1 , Triona Hayes  2 , Brian Bird  2 , Richard Flavin  1
Affiliations
Case Reports

Composite t(14;18)-Negative Follicular Lymphoma and Nodular Lymphocyte-Predominant Hodgkin Lymphoma

John Patrick O'Neill et al. Case Rep Hematol. .

Abstract

A composite lymphoma is the rare simultaneous occurrence of two or more distinct lymphomas within a single tissue or organ. Herein, we describe a case of a 51-year-old man presenting with a history of lower limb rash, fatigue, and bulky abdominopelvic lymphadenopathy. An excisional left iliac lymph node biopsy was notable for the composite presence of two distinct lymphoid neoplasms, nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), and follicular lymphoma (FL). Multiplex PCR and FISH analyses failed to demonstrate a t(14;18)(q32;q21) translocation in either composite lymphoma component. A clonal light-chain kappa (V/JC intron-kde) gene rearrangement was detected in the FL component only.

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Figures

Figure 1
Figure 1
NLPHL. (a) H&E staining, low power, showing vague nodular effacement. (b) H&E staining, high power, showing large LP cells (centre arrow) in a background population of small lymphocytes and histiocytes. (c) Immunostaining for EMA showing membrane positivity in LP cells. (d) Immunostaining for PD-1 showing positive membrane staining of T-cell rosettes surrounding LP cells.
Figure 2
Figure 2
Follicular lymphoma. (a) H&E staining, low power, showing pronounced nodular effacement by closely packed nodules lacking mantle zones. (b) H&E staining, high power, showing neoplastic follicle containing centroblasts (>15 per HPF). Immunostaining for (c) CD20 and (d) CD10 showing follicle positivity.
Figure 3
Figure 3
Fluorescence in situ hybridization photomicrograph of the follicular lymphoma component using LSI IGH/BCL2 t(14;18)(q32;q21) dual colour probes showing no evidence of t(14;18) translocation in nonoverlapped nuclei.
See this image and copyright information in PMC

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