A 3-way collision tumor of the upper respiratory tract: a composite of 2 immunophenotypically distinct mantle cell lymphomas and a plasmacytoma

Huan You Wang, Nitin Karandikar, Deborah Payne, Atousa Maleki, Barbara A. Schultz, Robert Collins, Robert W. McKenna

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Composite lymphoma (CL) is composed of 2 or more morphologically and immunophenotypically distinct lymphomas in a single anatomical site. Here we report a unique CL of the upper respiratory tract in an elderly male patient. Morphologically, the lymphoma was composed of 2 distinct and well-demarcated areas consisting of monotonous small to medium-sized lymphocytes and sheets of mature-appearing plasma cells. Immunophenotyping by both flow cytometry and immunohistochemistry revealed that the small to medium-sized lymphocytes were composed of 2 distinct subpopulations sharing a CD5+/CD19+/CD20+/CD22+/CD23-/FMC-7(+)/cyclin D1(+) immunophenotype but with different immunoglobulin (Ig) light and heavy chain expression, consistent with 2 immunophenotypically distinct mantle cell lymphomas (MCLs); the plasma cells were composed of CD38(bright +)/CD138+/IgG κ-restricted plasma cells, consistent with a plasmacytoma. Fluorescence in situ hybridization showed the t(11;14) translocation present in the lymphocyte region but absent in the plasma cell area. Ig heavy chain gene rearrangement studies on manually dissected populations showed 2 distinct patterns for the MCL and plasmacytoma. To our knowledge, this is the first report of a 3-way CL consisting of 2 immunophenotypically distinct MCLs and a plasmacytoma.

Original languageEnglish (US)
Pages (from-to)781-787
Number of pages7
JournalHuman Pathology
Volume39
Issue number5
DOIs
StatePublished - May 1 2008

Keywords

  • Composite lymphoma
  • Flow cytometry
  • Fluorescence in situ hybridization (FISH)
  • Mantle cell lymphoma
  • Plasmacytoma
  • Polymerase chain reaction (PCR)

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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