Abstract
Transformation of low-grade B cell lymphoproliferative disorders to high-grade lymphomas is a well-described occurrence. Transformation is considered the natural course of disease and is thought to result from a clonal evolution. Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) most commonly transforms to diffuse large B cell lymphoma, a process known as Richter transformation. Plasmablastic transformation of CLL/SLL is extremely rare. Here, we report a unique case of characteristic plasmablastic lymphoma (PBL) and CLL/SLL manifesting concurrently in the bone marrow of a patient with previously diagnosed CLL/SLL. The intimately admixed components represent two distinct morphologic and immunophenotypic populations of PBL and CLL/SLL. Cytogenetic/FISH analysis suggests a clonal evolution. Thus, PBL transformation may represent a new category of Richter transformation.
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