Sequential development of diffuse large B‐cell lymphoma in a patient with angioimmunoblastic T‐cell lymphoma

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Abstract
Lymphoma of different histologic type can occur in the same patient. Here, we describe a 64‐year‐old male patient with angioimmunoblastic T‐cell lymphoma (AITL) who subsequently developed diffuse large B‐cell lymphoma (DLBCL). At the time of initial diagnosis, histologic examination of a left inguinal lymph node of the patient and a monoclonal pattern of TCRβ gene rearrangement showed typical features of AITL, and there was no evidence of a monoclonal B‐cell population. Twenty‐six months later, he had generalized lymphadenopathy and organs involvement by DLBCL. A monoclonal IgH gene rearrangement proved de novo development of secondary B‐cell lymphoma and excluded relapse of a primary composite lymphoma. The in situ hybridization analysis showed Epstein‐Barr‐encoded RNA (EBER) sporadic positivity in sample collected from AITL but extensive positivity in the immunoblasts collected from DLBCL. Our observation supports the hypothesis that Epstein‐Barr virus (EBV) is etiologically related to AITL in this case. Clonal expansion of EBV‐associated DLBCL is a secondary event in AITL via EBV infection or reactivation. Diagn. Cytopathol. 2011;

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