A Case of a Diffuse Large B-Cell Lymphoma of Plasmablastic Type Associated With the t(2;5)(p23;q35) Chromosome Translocation

Anaplastic large cell lymphomas are associated with the t(2;5)(p23;q35) chromosome translocation in 40% to 60% of cases, leading to a new chimeric gene NPM-ALK. NPM-ALK positive lymphomas are generally reported to be of either T cell or null phenotype. In this report, we describe a diffuse large B-cell lymphoma associated with the classic t(2;5) translocation and both nuclear and cytoplasmic expression of ALK. The tumor consisted of medium-sized to large immunoblasts and plasmablasts that on immunohistology were negative for CD30, CD20, and CD79a but showed monotypic cytoplasmic expression of lambda light chains. Clonality analysis confirmed B-cell lineage of the tumor cells. The t(2;5)(p23;q35) chromosome translocation was demonstrated as part of a complex karyotypic alteration by classic banding and spectral karyotyping (SKY) analyses. Reverse transcription polymerase chain reaction confirmed rearrangement of NPM and ALK genes. This case exemplifies that the t(2;5) can, albeit rarely, occur in large B-cell lymphomas and is not entirely limited to anaplastic large cell lymphomas of T or null cell phenotypes.

[1]  P. Marynen,et al.  Identification of novel fusion partners of ALK, the anaplastic lymphoma kinase, in anaplastic large‐cell lymphoma and inflammatory myofibroblastic tumor , 2002, Genes, chromosomes & cancer.

[2]  R. Braziel,et al.  Immunoglobulin heavy chain gene analysis in lymphomas: a multi-center study demonstrating the heterogeneity of performance of polymerase chain reaction assays. , 2002, The Journal of molecular diagnostics : JMD.

[3]  P. Vyas,et al.  Pathology and genetics: Tumours of haematopoietic and lymphoid tissues , 2001 .

[4]  R. Braziel,et al.  Evaluation of T cell receptor testing in lymphoid neoplasms: results of a multicenter study of 29 extracted DNA and paraffin-embedded samples. , 2001, The Journal of molecular diagnostics : JMD.

[5]  S. Pileri,et al.  Anaplastic large‐cell lymphomas of B‐cell phenotype are anaplastic lymphoma kinase (ALK) negative and belong to the spectrum of diffuse large B‐cell lymphomas , 2000, British journal of haematology.

[6]  T. Greiner,et al.  Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma. , 1999, Blood.

[7]  S. Morris,et al.  The t(2;5) in human lymphomas. , 1998, Leukemia & lymphoma.

[8]  S. Pileri,et al.  ALK-positive lymphoma: a single disease with a broad spectrum of morphology. , 1998, Blood.

[9]  R. Alsabeh,et al.  Transformation of follicular lymphoma into CD30-large cell lymphoma with anaplastic cytologic features. , 1997, The American journal of surgical pathology.

[10]  P. Brousset,et al.  A new subtype of large B-cell lymphoma expressing the ALK kinase and lacking the 2; 5 translocation. , 1997, Blood.

[11]  K. Pulford,et al.  Detection of anaplastic lymphoma kinase (ALK) and nucleolar protein nucleophosmin (NPM)-ALK proteins in normal and neoplastic cells with the monoclonal antibody ALK1. , 1997, Blood.

[12]  D. Ledbetter,et al.  Multicolor Spectral Karyotyping of Human Chromosomes , 1996, Science.

[13]  D. Arber,et al.  Detection of the t(2;5)(p23;q35) chromosomal translocation in large B-cell lymphomas other than anaplastic large cell lymphoma. , 1996, Human pathology.

[14]  W. Chan,et al.  Occurrence of the t(2;5)(p23;q35) in non-Hodgkin's lymphoma. , 1996, Blood.

[15]  F. Mitelman,et al.  Catalog of Chromosome Aberrations in Cancer , 1996, British Journal of Cancer.

[16]  J. Downing,et al.  Molecular detection of the (2;5) translocation of non-Hodgkin's lymphoma by reverse transcriptase-polymerase chain reaction. , 1995, Blood.

[17]  M. Valentine,et al.  Sequence Correction , 1995, Science.

[18]  C. Pui,et al.  Clinicopathologic features and treatment outcome of children with large-cell lymphoma and the t(2;5)(p23;q35). , 1994, Blood.

[19]  D N Shapiro,et al.  Fusion of a kinase gene, ALK, to a nucleolar protein gene, NPM, in non-Hodgkin's lymphoma. , 1994, Science.

[20]  T. Glover.  Catalog of chromosome aberrations in cancer, 4th ed , 1992 .

[21]  J. Shuster,et al.  Use of an anti-ALK antibody in the characterization of anaplastic large-cell lymphoma of childhood. , 1997, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  A. Bernheim,et al.  High incidence of the t(2;5)(p23;q35) translocation in anaplastic large cell lymphoma and its lack of detection in Hodgkin's disease. Comparison of cytogenetic analysis, reverse transcriptase-polymerase chain reaction, and P-80 immunostaining. , 1996, Blood.