Blastoid Mantle Cell Variant of Richterâ€™s Transformation
The Journal of Clinical and Experimental Pathology (ISSN: 2161-0681) deals with research on infectious disorders associated with immune system and immunological disorders, infectious diseases, treatment of infectious diseases, infectious medicine, epidemiology, diagnostic tests of infectious diseases, infection control, pathophysiology, clinical pathology , preventive medicine. Clinical Pathology deals with patient care, diagnostic services, novel treatments and research on immune infections. Journal of Clinical & Experimental Pathology covers all areas of clinical and experimental pathology. Articles such as research papers, review articles, commentaries and short communications leading to the development of Journal of clinical and experimental pathology.
An unusual occurrence of blastoid variant of mantle cell lymphoma arising in a patient with untreated chronic lymphocytic leukemia/small lymphocytic lymphoma is described. A localized site of intense uptake on positron emission tomography suggested Richter’s transformation. Biopsy of the suspect area showed the blastoid variant of mantle cell lymphoma. Immunohistochemistry and fluorescence in situ hybridization confirmed the identity of both tumors. Molecular studies established that the mantle cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma were clonally related.
Richter’s transformation (RT) is usually defined as the occurrence of diffuse large B-cell lymphoma (DLBCL) arising in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/ SLL). Transformation to the Hodgkin lymphoma variant is a considerably less frequent event. We report the unusual occurrence of blastoid mantle cell lymphoma (MCL) variant of Richter’s transformation in a previously untreated patient with CLL/SLL. Transformation was signaled by interval changes in fluorodeoxyglucose (18FDG) positron emission tomography.
Richter’s transformation of CLL/SLL to the blastoid variant of mantle cell lymphoma has not been previously reported. Ðat unusual event evolved in the setting of untreated CLL/SLL with high risk features; advanced Rai stage, elevated LDH, trisomy 12, and mutated NOTCH1. PET imaging detected the area of transformation, which then led to incisional biopsy and repeat staging. Molecular studies confirmed the clonal relatedness of the MCL and CLL/SLL.
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