Primary bone marrow T-cell anaplastic large cell lymphoma with triple m gradient Árpád Szomor Email author Talal Al Saati Georges Delsol László Kereskai Zsuzsanna Szijártó Hajna Losonczy Case Report Received: 15 November 2006 Accepted: 15 July 2007 DOI :
10.1007/BF02893508
Cite this article as: Szomor, Á., Saati, T.A., Delsol, G. et al. Pathol. Oncol. Res. (2007) 13: 260. doi:10.1007/BF02893508 Abstract We present a case of a 60-year-old male patient with primary bone marrow anaplastic large cell lymphoma. He was admitted to the hospital with the symptoms of anemia and fever. There was no evidence of lymphadenopathy or splenomegaly. Immunoelectrophoresis showed the presence of a triple M gradient (double IgM and an IgG), with the IgG and one of the IgM paraproteins functioning as a cryoglobulin. The patient had no hepatitis C virus infection. Bone marrow biopsy showed massive CD30-positive, ALK-negative large lymphoid cell infiltration of T-cell origin with anaplastic morphology. PCR analysis of lymphoid cells separated from the bone marrow demonstrated the presence of a B/T hybrid genotype disorder with no evidence of the t(2;5), nor t(1;2) translocations. The patient entered a period of remission following CHOP chemotherapy. The patient subsequently died of sepsis as a consequence of serious humoral immunodeficiency.
Key words anaplastic large cell lymphoma T-cell receptor gene rearrangement immunoglobulin heavy chain gene rearrangement M gradient bone marrow Abbreviations PCR polymerase chain reaction
IgH immunoglobulin heavy chain
TCR T-cell receptor
RT-PCR reverse transcriptase polymerase chain reaction
ALK anaplastic lymphoma kinase
CHOP cyclophosphamide-hydroxy epirubicine-oncovin-pred-nisolone
ALCL anaplastic large cell lymphoma
HCV hepatitis C virus
HBsAg hepatitis B surface antigen
MDR multi-drug resistance
WHO World Health Organization
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Authors and Affiliations Árpád Szomor Email author Talal Al Saati Georges Delsol László Kereskai Zsuzsanna Szijártó Hajna Losonczy 1. 1st Department of Medicine University of Pécs Pécs Hungary 2. Institute of Pathology University of Pécs Hungary 3. Department of Ophthalmology University of Pécs Hungary 4. Laboratory of Anatomic Pathology Central Hospital University Purpan Toulouse France