[Diffuse large B-cell lymphoma occurring in a Waldenström macroglobulinemia patient with central nervous system infiltration].

Abstract

The rare central nervous system (CNS) infiltration of Waldenström macroglobulinemia (WM) is known as Bing-Neel syndrome (BNS). Furthermore, the transformation of WM into diffuse large B-cell lymphoma (DLBCL) is also unusual. Herein, we report a 69-year-old male with DLBCL transformed from BNS. In November 2008, the patient visited a prior hospital because of anemia and was diagnosed with WM. After receiving chemotherapy (R-CHOP), his serum immunoglobulin M (IgM) level decreased and then remained at approximately 2000 mg/dl for 3 years. In November 2011, he complained of visual impairment and photophobia in his left eye. Magnetic resonance imaging showed enlargement of the left optic nerve and cerebrospinal fluid examination indicated CNS infiltration of WM cells. Consequently, he was diagnosed with BNS. He thus received CNS targeted chemotherapy (R-MPV) and achieved a partial response. In May 2014, IgM was elevated and swelling of systemic lymph nodes was detected. Inguinal lymph node biopsy yielded a pathological diagnosis of DLBCL and the clonality of tumor cells between WM and DLBCL was confirmed by the allele-specific oligonucleotide polymerase chain reaction (ASO-PCR).

• Authors: Yuto Hayashi, Hiroshi Sata, Keigo Akuta, Jun Toda, Shinsuke Kusakabe, Tomoaki Ueda, Yasutaka Ueda, Jiro Fujita, Seiji Tadokoro, Tetsuo Maeda, Junichi Nishimura, Hirohiko Shibayama, Kenji Oritani, Yuzuru Kanakura
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 56 Issue 11 Pg. 2351-6 (Nov 2015) ISSN: 0485-1439 [Print] Japan
• PMID: 26666724 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Immunoglobulin Heavy Chains

Topics

• Aged
• Central Nervous System (pathology)
• Gene Rearrangement
• Humans
• Immunoglobulin Heavy Chains (genetics)
• Lymph Nodes (pathology)
• Lymphoma, Large B-Cell, Diffuse (complications, drug therapy, genetics, pathology)
• Male
• Waldenstrom Macroglobulinemia (etiology, genetics)