Simultaneous Presentation of B- and T-Cell Malignant Lymphoma

Abstract

Multiclonal NHL of the B-cell type has been described [1, 2], most often when two histological types of lymphoma have been noted in simultaneous or successive biopsies. This occurs predominantly when follicular centre cell (FCC) histology converts into a large cell diffuse histology [2]. Multiclonal disease of the B-cell type has been noted in heavily immunosuppressed patients [3]. Reports of composite lymphoma with diffuse T-cell histology arising from co-existant FCC have been described on morphological and immunological evidence [4–6]; however, no DNA analysis was reported. Recently, a multiclonal lymphoma, confirmed by DNA analysis, was reported with sequential B- and T-cell clones [7] in a patient with autoimmune disease who received chemotherapy for the initial B-cell lymphoma.