Clonal evolution of chronic lymphocytic leukemia to Langerhans cell histiocytosis: a case report.


Journal

Virchows Archiv : an international journal of pathology
ISSN: 1432-2307
Titre abrégé: Virchows Arch
Pays: Germany
ID NLM: 9423843

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 08 03 2019
accepted: 11 06 2019
revised: 30 04 2019
pubmed: 19 7 2019
medline: 21 12 2019
entrez: 19 7 2019
Statut: ppublish

Résumé

The traditional concept of unidirectional maturation of hematopoietic cells has been called into question due to the recognition of lineage plasticity, which is increasingly found also in the clonal evolution of hematopoietic and lymphoid malignancies. Here we present an unusual case of a patient with TP53-mutated chronic lymphocytic leukemia (CLL) treated with a PI3Kδ inhibitor evolving to clonally related Langerhans cell histiocytosis (LCH) with acquired BRAF V600E and STK11 mutations and loss of expression of PAX-5 and other examined B cell markers. In indolent B cell lymphoma, transformation to a more aggressive high-grade lymphoma occurs frequently during the course of disease and is thought to be caused by clonal evolution. Our case further supports the concept of significant lineage plasticity in lymphomas and raises the question of a potential role of novel pharmacologic agents in clonal evolution.

Identifiants

pubmed: 31317311
doi: 10.1007/s00428-019-02608-7
pii: 10.1007/s00428-019-02608-7
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

795-798

Subventions

Organisme : TUEFF
ID : project 2320-0-0

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Auteurs

Leonie Frauenfeld (L)

Institute of Pathology and Neuropathology, Comprehensive Cancer Center and University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tübingen, Germany.

Irina Bonzheim (I)

Institute of Pathology and Neuropathology, Comprehensive Cancer Center and University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tübingen, Germany.

Stefan Wirths (S)

Medical Department, Hematology and Oncology, Comprehensive Cancer Center Tuebingen, University of Tuebingen, Tübingen, Germany.

Julia Steinhilber (J)

Institute of Pathology and Neuropathology, Comprehensive Cancer Center and University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tübingen, Germany.

Marius Horger (M)

Department for Radiology, Comprehensive Cancer Center Tuebingen, University of Tuebingen, Tübingen, Germany.

Barbara Mankel (B)

Institute of Pathology and Neuropathology, Comprehensive Cancer Center and University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tübingen, Germany.

Wolfgang Bethge (W)

Medical Department, Hematology and Oncology, Comprehensive Cancer Center Tuebingen, University of Tuebingen, Tübingen, Germany.

Falko Fend (F)

Institute of Pathology and Neuropathology, Comprehensive Cancer Center and University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tübingen, Germany. falko.fend@med.uni.tuebingen.de.

Birgit Federmann (B)

Institute of Pathology and Neuropathology, Comprehensive Cancer Center and University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tübingen, Germany.

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Classifications MeSH