Clinical Case Database / Category: Patient Management

Diffuse large B-cell lymphoma occurring in a patient with hairy cell leukemia and prostatic adenocarcinoma

Publication details

G Anghel, MD, Gabriel Anghel, MD
Foundation Years Journal, volume 5, issue 7, p.35 (123Doc Education, London, August 2011)

Abstract

A 75 year-old man with previous history (of prostatic adenocarcinoma) was referred for evaluation of pancytopenia in December 2006. A diagnosis of hairy cell leukaemia (HCL) was made. The patient was commenced 2 cloro-deoxyadenosine treatment, attaining a complete remission. Four months later he presented with inguinal & supraclavicular lymphadenopathy, and hypercalcemia. A lymph node biopsy revealed infiltration by diffuse large B cell lymphoma (DLBCL). Though HCL is associated with increase incidence of second malignancies, simultaneous occurrence of DLBCL and HCL remains an uncommon event. A literature review showed only 13 cases have been published to date. The origin and clonal relationship of heavy or light chains immunoglobulin genes in the two pathologies is also discussed.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Authors

G Anghel, MD

Consultant Haematologist

Gabriel Anghel, MD

Consultant Haematologist,
Haematology Dept. - LCH,
United Lincolnshire Hospitals NHS Foundation Trust,
Greetweel Road, Lincoln. LN2 5QY

References

1. Bouroncle BA: Leukemic reticuloendotheliosis (hairy cell leukaemia). Blood 1979; 53: 412-436.
2. Friedline JA, Crisan D, Chen J: Blastic transformation in a case of hairy cell leukaemia Mol Diagn 1998; 3: 163-169.
3. Adler SS, Shetty J, Golomb HM: Coexistence of leukemic reticuloendotheliosis and histyocytic lymphoma. Cancer 1979; 43: 1872-1880.
4. Fransilla KO: coincidental hairy cell leukaemia and large cell malignant lymphoma. Arch Pathol Lab Med 1979; 103: 437-439.
5. Vardiman JW, Variakojis D, Golomb HM: Hairy cell leukaemia: An autopsy study. Cancer, 1979; 43: 1339-1349.
6. Davis KM, Spindle E, Franzini DA, et al. Anaplastic neoplasm in a patient with hairy cell leukaemia. Cancer 1985; 56: 2470-5.
7. Downing JR, Grossi CE, Smedberg CT, et al. Diffuse large cell lymphoma in a patient with hairy cell leukaemia: immunoglobulin gene analysis reveals separate clonal origin, Blood 1986; (67) 3: 739-744.
8. Arnalich F, Camacho J, Jimenez C, et al. Occurrence of Immunoblastic B-cell lymphoma in hairy cell leukaemia, Cancer 1987; 59: 1161-1164.
9. Huang AT, Silverstein L, Gonias SL, et al. Transformation of hairy cell leukaemia to EBV genome-containing aggressive B cell lymphoma. Leukemia 1987; 1: 369-72.
10. Lawlor E, O'Brian SD, Finn T, et al. The simultaneous presentation of peripheral T-cell lymphoma and hairy cell leukaemia. Cancer 1987; 60: 1537-44.
11. Susan L, Abbondanzo, Laura E Sulak, Ki-1-positive lymphoma developing 10 years after the diagnosis of hairy cell leukaemia, Cancer 1991; 15: 3117-22.
12. Lopera GA, Alvarez OA, Lee M: Large cell lymphoma of the colon presenting as a second malignancy in a patient with hairy cell leukaemia. J Clin gastroenterol 1995; 21: 259-260.
13. Nazeer T, Burkart P, Dunn H et al. Blastic transformation of hairy cell leukaemia. Arch Pathol Lab Med 1997; 121: 707-713.
14. Tsieh Sun, Nichon Grupka, Catherine Klein transformation of hairy cell leukemia to high grade lymphoma: a case report and review of the literature, Human Pathology 2004; (35), 11: 1423-6.
15. Au WY, Klasa RJ, Gallagher R, et al. Second malignancies in patients with hairy cell leukaemia in British Columbia: a 20-year experience. Blood 1998; (92): 1160-4.
16. Federico M Zinzani PL, Frassaldati A, et al. Risk of second cancer in patients with hairy cell leukemia: long term follow-up. Journal Clin Oncol, 2002 (3): 638 – 46.
17. Kurzrock R, Strom SS, Estey E, et al. Second cancer risk in hairy cell leukemia: analysis of 350 patients. J Clin Oncol. 1997; 15: 1803 - 10.

Disclaimers

Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.