Clonally related follicular lymphomas and langerhans cell neoplasms: Expanding the spectrum of transdifferentiation

Dava S. West, Ahmet Dogan, Patrick S. Quint, Melissa L. Tricker-Klar, Julie C. Porcher, Rhett P. Ketterling, Mark E. Law, Ellen McPhail, David S. Viswanatha, Paul J. Kurtin, Linda N. Dao, Ryan D. Ritzer, Grzegorz S Nowakowski, Andrew L Feldman

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

The traditional model of hematopoiesis is based on unidirectional maturation of hematopoietic precursors into lineage- committed cells. However, recent studies indicate that mature B lymphocytes may demonstrate significant lineage plasticity. We and others have reported transdifferentiation of follicular lymphomas (FLs) into clonally related histiocytic/ dendritic cell neoplasms. Here, we describe 2 patients with FL who developed clonally related Langerhans cell neoplasms. The first was a 52-year-old man diagnosed with FL, grade 1. He received immunochemotherapy and had stable disease for 8 years. He then developed increasing lymphadenopathy, and lymph node biopsy showed Langerhans cell sarcoma with no evidence of FL. The second patient was a 77-year-old woman who presented with lymphadenopathy, an abdominal mass, and pulmonary nodules. Lymph node biopsy showed both Langerhans cell histiocytosis and minimal involvement by FL, grade 1. In each case, a combination of immunoglobulin gene rearrangement and fluorescence in situ hybridization studies provided evidence to support a clonal relationship between the FL and Langerhans cell neoplasm. These cases provide striking examples of neoplastic transdifferentiation and expand the spectrum of lesions clonally identical to otherwise typical FL. Awareness of this phenomenon may aid in diagnosis when histologically dissimilar tumors arise synchronously or metachronously in patients with lymphoma.

Original languageEnglish (US)
Pages (from-to)978-986
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number7
DOIs
StatePublished - Jul 2013

Fingerprint

Follicular Lymphoma
Langerhans Cells
Neoplasms
Langerhans Cell Sarcoma
Lymph Nodes
Biopsy
Langerhans Cell Histiocytosis
Immunoglobulin Genes
Gene Rearrangement
Hematopoiesis
Fluorescence In Situ Hybridization
Dendritic Cells
Lymphoma
B-Lymphocytes
Lung

Keywords

  • Follicular lymphoma
  • Langerhans cell histiocytosis
  • Langerhans cell sarcoma
  • Lineage plasticity
  • Transdifferentiation
  • Transformation

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Clonally related follicular lymphomas and langerhans cell neoplasms : Expanding the spectrum of transdifferentiation. / West, Dava S.; Dogan, Ahmet; Quint, Patrick S.; Tricker-Klar, Melissa L.; Porcher, Julie C.; Ketterling, Rhett P.; Law, Mark E.; McPhail, Ellen; Viswanatha, David S.; Kurtin, Paul J.; Dao, Linda N.; Ritzer, Ryan D.; Nowakowski, Grzegorz S; Feldman, Andrew L.

In: American Journal of Surgical Pathology, Vol. 37, No. 7, 07.2013, p. 978-986.

Research output: Contribution to journalArticle

West, DS, Dogan, A, Quint, PS, Tricker-Klar, ML, Porcher, JC, Ketterling, RP, Law, ME, McPhail, E, Viswanatha, DS, Kurtin, PJ, Dao, LN, Ritzer, RD, Nowakowski, GS & Feldman, AL 2013, 'Clonally related follicular lymphomas and langerhans cell neoplasms: Expanding the spectrum of transdifferentiation', American Journal of Surgical Pathology, vol. 37, no. 7, pp. 978-986. https://doi.org/10.1097/PAS.0b013e318283099f
West, Dava S. ; Dogan, Ahmet ; Quint, Patrick S. ; Tricker-Klar, Melissa L. ; Porcher, Julie C. ; Ketterling, Rhett P. ; Law, Mark E. ; McPhail, Ellen ; Viswanatha, David S. ; Kurtin, Paul J. ; Dao, Linda N. ; Ritzer, Ryan D. ; Nowakowski, Grzegorz S ; Feldman, Andrew L. / Clonally related follicular lymphomas and langerhans cell neoplasms : Expanding the spectrum of transdifferentiation. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 7. pp. 978-986.
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