Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation
Lymphadenopathy in chronic myeloid leukemia (CML) is usually due to extramedullary involvement with accelerated or blast phases of the disease. The occurrence of non-Hodgkin lymphoma (NHL) as a synchronous malignancy with CML is rare. We report a case of a 73-year-old male who presented with dyspnea...
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Wiley
2018-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2018/7493601 |
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| author | Amy G. Starr Sushma R. Jonna Joeffrey J. Chahine Bhaskar V. Kallakury Chaitra S. Ujjani |
| author_facet | Amy G. Starr Sushma R. Jonna Joeffrey J. Chahine Bhaskar V. Kallakury Chaitra S. Ujjani |
| author_sort | Amy G. Starr |
| collection | DOAJ |
| description | Lymphadenopathy in chronic myeloid leukemia (CML) is usually due to extramedullary involvement with accelerated or blast phases of the disease. The occurrence of non-Hodgkin lymphoma (NHL) as a synchronous malignancy with CML is rare. We report a case of a 73-year-old male who presented with dyspnea and right-sided lower extremity edema in the setting of leukocytosis. Bone marrow evaluation indicated a chronic phase chronic myeloid leukemia (CML), confirmed by molecular testing. Imaging of the chest for persistent dyspnea revealed supraclavicular and mediastinal lymphadenopathy. Biopsy of the cervical node showed expanded lymphoid follicles with atypical germinal centers that were positive for CD10, BCL-2, and BCL-6, consistent with follicular lymphoma (FL). Nodal PCR demonstrated clonal IGH and IGK gene rearrangements, and FISH analysis was positive for IGH-BCL-2 fusion. Together, these tests supported the diagnosis of FL. Additionally, the lymph node showed paracortical expansion by maturing pan-hematopoietic elements, no blastic groups, and positive RT-PCR analysis for BCR-ABL1, indicating concomitant involvement by chronic phase-CML. To our knowledge, this is the first reported case of a patient with a concurrent diagnosis of CML and FL. |
| format | Article |
| id | doaj-art-c515e78dab7e4a819d010bd7dc8ff87f |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Case Reports in Hematology |
| spelling | doaj-art-c515e78dab7e4a819d010bd7dc8ff87f2025-02-03T07:24:58ZengWileyCase Reports in Hematology2090-65602090-65792018-01-01201810.1155/2018/74936017493601Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported PresentationAmy G. Starr0Sushma R. Jonna1Joeffrey J. Chahine2Bhaskar V. Kallakury3Chaitra S. Ujjani4MedStar Georgetown University Hospital, Department of Pathology, 3800 Reservoir Rd NW, Medical Dental Building, SE 200, Washington, DC 20007, USALombardi Comprehensive Cancer Center, Department of Hematology and Oncology, MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, Washington, DC 20007, USAMedStar Georgetown University Hospital, Department of Pathology, 3800 Reservoir Rd NW, Medical Dental Building, SE 200, Washington, DC 20007, USAMedStar Georgetown University Hospital, Department of Pathology, 3800 Reservoir Rd NW, Medical Dental Building, SE 200, Washington, DC 20007, USALombardi Comprehensive Cancer Center, Department of Hematology and Oncology, MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, Washington, DC 20007, USALymphadenopathy in chronic myeloid leukemia (CML) is usually due to extramedullary involvement with accelerated or blast phases of the disease. The occurrence of non-Hodgkin lymphoma (NHL) as a synchronous malignancy with CML is rare. We report a case of a 73-year-old male who presented with dyspnea and right-sided lower extremity edema in the setting of leukocytosis. Bone marrow evaluation indicated a chronic phase chronic myeloid leukemia (CML), confirmed by molecular testing. Imaging of the chest for persistent dyspnea revealed supraclavicular and mediastinal lymphadenopathy. Biopsy of the cervical node showed expanded lymphoid follicles with atypical germinal centers that were positive for CD10, BCL-2, and BCL-6, consistent with follicular lymphoma (FL). Nodal PCR demonstrated clonal IGH and IGK gene rearrangements, and FISH analysis was positive for IGH-BCL-2 fusion. Together, these tests supported the diagnosis of FL. Additionally, the lymph node showed paracortical expansion by maturing pan-hematopoietic elements, no blastic groups, and positive RT-PCR analysis for BCR-ABL1, indicating concomitant involvement by chronic phase-CML. To our knowledge, this is the first reported case of a patient with a concurrent diagnosis of CML and FL.http://dx.doi.org/10.1155/2018/7493601 |
| spellingShingle | Amy G. Starr Sushma R. Jonna Joeffrey J. Chahine Bhaskar V. Kallakury Chaitra S. Ujjani Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation Case Reports in Hematology |
| title | Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation |
| title_full | Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation |
| title_fullStr | Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation |
| title_full_unstemmed | Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation |
| title_short | Concurrent Diagnosis of Chronic Myeloid Leukemia and Follicular Lymphoma: An Unreported Presentation |
| title_sort | concurrent diagnosis of chronic myeloid leukemia and follicular lymphoma an unreported presentation |
| url | http://dx.doi.org/10.1155/2018/7493601 |
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