Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: Evidence for transdifferentiation of the follicular lymphoma clone

Andrew L. Feldman, Daniel A. Arber, Stefania Pittaluga, Antonio Martinez, Jerome S. Burke, Mark Raffeld, Mireia Camos, Roger Warnke, Elaine S. Jaffe

Research output: Contribution to journalArticle

188 Scopus citations

Abstract

Rare cases of histiocytic and dendritic cell (H/DC) neoplasms have been reported in patients with follicular lymphoma (FL), but the biologic relationship between the 2 neoplasms is unknown. We studied 8 patients with both FL and H/DC neoplasms using immunohistochemistry, fluorescence in situ hybridization (FISH) for t(14;18), and polymerase chain reaction (PCR)/sequencing of BCL2 and IGH rearrangements. There were 5 men and 3 women (median age, 59 years). All cases of FL were positive for t(14;18). The H/DC tumors included 7 histiocytic sarcomas, 5 of which showed evidence of dendritic differentiation, and 1 interdigitating cell sarcoma. Five H/DC tumors were metachronous, following FL by 2 months to 12 years; tumors were synchronous in 3. All 8 H/DC tumors showed presence of the t(14;18) either by FISH, or in 2 cases by PCR with the major breakpoint region (MBR) probe. PCR and sequencing identified identical IGH gene rearrangements or BCL2 gene breakpoints in all patients tested. All H/DC tumors lacked PAX5, and up-regulation of CEBPβ and PU.1 was seen in all cases tested. These results provide evidence for a common clonal origin of FL and H/DC neoplasms when occurring in the same patient, and suggest that lineage plasticity may occur in mature lymphoid neoplasms.

Original languageEnglish (US)
Pages (from-to)5433-5439
Number of pages7
JournalBlood
Volume111
Issue number12
DOIs
StatePublished - Jun 15 2008

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Feldman, A. L., Arber, D. A., Pittaluga, S., Martinez, A., Burke, J. S., Raffeld, M., Camos, M., Warnke, R., & Jaffe, E. S. (2008). Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: Evidence for transdifferentiation of the follicular lymphoma clone. Blood, 111(12), 5433-5439. https://doi.org/10.1182/blood-2007-11-124792