Lab Med Online.  2016 Apr;6(2):98-101. 10.3343/lmo.2016.6.2.98.

A Case of Coexistence of Bone Marrow-involved Refractory Marginal Zone B-Cell Lymphoma and Therapy-related Myelodysplastic Syndrome

• Song I
• Park CJ
• Cho YU
• Seo EJ
• Lee JH
• Suh CW
• Jang S

• KMID: 2160091
• DOI: http://doi.org/10.3343/lmo.2016.6.2.98

Abstract

Recent advances in chemotherapy have led to increased survival rates for patients with hematologic malignancies. However, standard chemotherapies, including alkylating agents for non-Hodgkin lymphoma, could induce therapy-related myeloid neoplasms (t-MNs), a group of disorders categorized by the World Health Organization in 2008. Here, we report a case of coexistence of bone marrow (BM)-involved refractory marginal zone B-cell lymphoma (MZL) and therapy-related myelodysplastic syndrome (t-MDS). Simultaneous presence of refractory lymphoma and t-MN in the BM is rare, and this is the first report in Korea. The patient received allogeneic hematopoietic stem cell transplantation (HSCT) to cure both the MZL and t-MDS. Since the HSCT, he has been stable for 21 months without any evidence of recurrence.

Keyword

Bone marrow; Therapy-related myelodysplastic syndrome; Marginal zone B-cell lymphoma; Allogeneic hematopoietic stem cell transplantation

MeSH Terms

Alkylating Agents
Bone Marrow
Drug Therapy
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Korea
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Lymphoma, Non-Hodgkin
Myelodysplastic Syndromes*
Recurrence
Survival Rate
World Health Organization
Alkylating Agents

Figure

• 

  Fig. 1 Bone marrow (BM) findings of coexistence of BM-involved refractory marginal zone B-cell lymphoma and therapy-related myelodysplastic syndrome. (A) Neoplastic lymphoid cells (black arrow) and increased number of myeloblasts (red arrow) (BM aspirate, Wright stain, ×1,000). (B) Nodular infiltration of lymphoma cells (black arrow) and an area with increased number of myeloblasts (red arrow) (BM biopsy, H & E stain, ×400). (C) CD20-positive lymphoma cells in a lymphoid nodule (BM biopsy, immunohistochemistry for CD20, ×1,000). (D) Increased number of CD34-positive myeloblasts (BM clot section, immunohistochemistry for CD34, ×400). (E) Increased number of immature myeloid cells (BM clot section, immunohistochemistry for CD117, ×400).

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