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Relapse of follicular lymphoma arising from a non‐t(14;18) clone

Intraclonal diversity is commonly observed in patients with follicular lymphoma (FL), whereas tumor cells at the onset and relapse usually share early genetic events such as VDJ rearrangement of the immunoglobulin genes and t(14;18) translocation. We report a case of FL with relapse with FL that was...

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Autores principales: Otsuka, Yasuyuki, Nishikori, Momoko, Fujimoto, Masakazu, Nakao, Kensuke, Hishizawa, Masakatsu, Haga, Hironori, Takaori‐Kondo, Akifumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176117/
https://www.ncbi.nlm.nih.gov/pubmed/35847735
http://dx.doi.org/10.1002/jha2.28
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author Otsuka, Yasuyuki
Nishikori, Momoko
Fujimoto, Masakazu
Nakao, Kensuke
Hishizawa, Masakatsu
Haga, Hironori
Takaori‐Kondo, Akifumi
author_facet Otsuka, Yasuyuki
Nishikori, Momoko
Fujimoto, Masakazu
Nakao, Kensuke
Hishizawa, Masakatsu
Haga, Hironori
Takaori‐Kondo, Akifumi
author_sort Otsuka, Yasuyuki
collection PubMed
description Intraclonal diversity is commonly observed in patients with follicular lymphoma (FL), whereas tumor cells at the onset and relapse usually share early genetic events such as VDJ rearrangement of the immunoglobulin genes and t(14;18) translocation. We report a case of FL with relapse with FL that was clonally different from the tumor cells at onset. A 59‐year‐old male presented with paraaortic lymph node swelling and thickening of the right renal pelvic and ureteral wall was histologically diagnosed as FL, grade 1. Karyotypic analysis revealed t(14;18)(q32;q21) with +12 and +der(18)t(14;18). Ten years after the initial diagnosis, he suddenly developed systemic lymphadenopathy as a second relapse, and histological examination led to the diagnosis of FL grade 3B with diffuse large B‐cell lymphoma. Surprisingly, karyotypic analysis demonstrated the presence of +12 and 3q27 abnormality, which was proved to be a BCL6 translocation by fluorescence in situ hybridization, but the absence of t(14;18)(q32;q21). We compared VDJ rearrangement of the FL cells at onset and relapse and found that they were completely independent of each other. These tumor cells sharetrisomy 12 as a common genetic abnormality, and it is speculated that trisomy 12 may have occurred earlier than BCL2 and BCL6 translocations. These results suggest that there can even be cases of “relapse” of FL with an independent origin of the primary tumor cells. Our observation highlights the importance of re‐biopsy of relapsed FL, especially when it occurs after a long remission with different clinical presentation from that at the onset.
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spelling pubmed-91761172022-07-14 Relapse of follicular lymphoma arising from a non‐t(14;18) clone Otsuka, Yasuyuki Nishikori, Momoko Fujimoto, Masakazu Nakao, Kensuke Hishizawa, Masakatsu Haga, Hironori Takaori‐Kondo, Akifumi EJHaem Case Reports Intraclonal diversity is commonly observed in patients with follicular lymphoma (FL), whereas tumor cells at the onset and relapse usually share early genetic events such as VDJ rearrangement of the immunoglobulin genes and t(14;18) translocation. We report a case of FL with relapse with FL that was clonally different from the tumor cells at onset. A 59‐year‐old male presented with paraaortic lymph node swelling and thickening of the right renal pelvic and ureteral wall was histologically diagnosed as FL, grade 1. Karyotypic analysis revealed t(14;18)(q32;q21) with +12 and +der(18)t(14;18). Ten years after the initial diagnosis, he suddenly developed systemic lymphadenopathy as a second relapse, and histological examination led to the diagnosis of FL grade 3B with diffuse large B‐cell lymphoma. Surprisingly, karyotypic analysis demonstrated the presence of +12 and 3q27 abnormality, which was proved to be a BCL6 translocation by fluorescence in situ hybridization, but the absence of t(14;18)(q32;q21). We compared VDJ rearrangement of the FL cells at onset and relapse and found that they were completely independent of each other. These tumor cells sharetrisomy 12 as a common genetic abnormality, and it is speculated that trisomy 12 may have occurred earlier than BCL2 and BCL6 translocations. These results suggest that there can even be cases of “relapse” of FL with an independent origin of the primary tumor cells. Our observation highlights the importance of re‐biopsy of relapsed FL, especially when it occurs after a long remission with different clinical presentation from that at the onset. John Wiley and Sons Inc. 2020-06-03 /pmc/articles/PMC9176117/ /pubmed/35847735 http://dx.doi.org/10.1002/jha2.28 Text en © 2020 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Otsuka, Yasuyuki
Nishikori, Momoko
Fujimoto, Masakazu
Nakao, Kensuke
Hishizawa, Masakatsu
Haga, Hironori
Takaori‐Kondo, Akifumi
Relapse of follicular lymphoma arising from a non‐t(14;18) clone
title Relapse of follicular lymphoma arising from a non‐t(14;18) clone
title_full Relapse of follicular lymphoma arising from a non‐t(14;18) clone
title_fullStr Relapse of follicular lymphoma arising from a non‐t(14;18) clone
title_full_unstemmed Relapse of follicular lymphoma arising from a non‐t(14;18) clone
title_short Relapse of follicular lymphoma arising from a non‐t(14;18) clone
title_sort relapse of follicular lymphoma arising from a non‐t(14;18) clone
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176117/
https://www.ncbi.nlm.nih.gov/pubmed/35847735
http://dx.doi.org/10.1002/jha2.28
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