Composite lymphoma with coexistence of diffuse large B-cell lymphoma and anaplastic large cell lymphoma: Diagnostic pitfalls

Indian J Pathol Microbiol. 2017 Apr-Jun;60(2):275-278. doi: 10.4103/IJPM.IJPM_139_16.

Abstract

Composite lymphoma is a rare tumor composed of two or more distinct lymphomas in the same topographic site or tissue. Several combinations of B-cell non-Hodgkin lymphoma (NHL), T-cell NHL, and Hodgkin lymphoma can occur with different prognoses and treatments. The coexistence of a B-cell NHL and a T-cell NHL is unusual. The exact etiology of composite lymphoma is unknown; however, few mechanisms have been proposed to explain its pathogenesis. The chemotherapeutic protocols are heterogeneous but are essentially targeted against the high-grade component. Most of the cases show worse outcome with a median survival of 12 months. In this article, we report a case of composite lymphoma which was initially diagnosed as diffuse large B-cell lymphoma, and the presence of CD3-positive atypical cells in the bone marrow urged us to re-evaluate the lymph node biopsy following which a focus of Alk-1-positive anaplastic large cell lymphoma was identified.

Publication types

  • Case Reports

MeSH terms

  • Activin Receptors, Type II / analysis
  • Bone Marrow / pathology
  • CD3 Complex / analysis
  • Composite Lymphoma / diagnosis*
  • Composite Lymphoma / pathology
  • Cytological Techniques
  • Humans
  • Immunohistochemistry
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / diagnosis*
  • Lymphoma, B-Cell / pathology
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large-Cell, Anaplastic / complications
  • Lymphoma, Large-Cell, Anaplastic / diagnosis*
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Male
  • Microscopy
  • Middle Aged

Substances

  • CD3 Complex
  • ACVRL1 protein, human
  • Activin Receptors, Type II