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Hipercalcemia, peak monoclonal y leucemización como presentación de un linfoma de células B de alto grado, con reordenamiento de MYC, BCL-2 y BCL-6 (Triple Hit). Caso clínico / Hypercalcemia, monoclonal peak and leukemic presentation of a High-grade B-cell lymphoma with MYC, BCL-2 and BCL-6 translocations (triple hit). Report of one case
Peña, Camila; Marti, María José; Villegas, Pablo; Undurraga, María Soledad.
  • Peña, Camila; Hospital del Salvador. Sección de Hematología. Unidad de Hematología Clínica. Santiago. CL
  • Marti, María José; Hospital del Salvador. Sección de Hematología. Unidad de Hematología Clínica. Santiago. CL
  • Villegas, Pablo; Hospital del Salvador. Sección de Hematología. Unidad de Hematología Clínica. Santiago. CL
  • Undurraga, María Soledad; Hospital del Salvador. Sección de Hematología. Unidad de Hematología Clínica. Santiago. CL
Rev. méd. Chile ; 145(11): 1485-1489, nov. 2017. graf
Article in Spanish | LILACS | ID: biblio-902470
RESUMEN
High-grade B-cell lymphomas with rearrangement of MYC, BCL-2 and/or BCL-6 were introduced by the update of the WHO classification of lymphoid neoplasms. They usually present unique morphological and molecular characteristics, with an aggressive clinical outcome and worse prognosis. We report a 48 year-old female patient presenting with B symptoms and enlarged lymph nodes. Blood count showed pancytopenia and peripheral blood smears showed large lymphoid cells, some with nuclei and vacuoles. LDH was 3524 g/L and serum calcium was 11.5 mg/dL. Flow cytometry immunophenotyping showed pathological mature B lymphocytes. Protein electrophoresis showed a slight monoclonal peak. The biopsy disclosed a triple expressor diffuse large B-cell lymphoma, arising from germinal center. FISH was positive for MYC, BCL-2 and BCL-6 (triple hit) with a clonal evolution. Conventional cytogenetics showed a complex karyotype. Chemotherapy was started with R-CHOP (Rituximab/cyclophosphamide/doxorubicin/vincristine/prednisone). She developed impaired consciousness; the brain CT scan showed a large brain mass. The patient died within 3 weeks.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Translocation, Genetic / Lymphoma, Large B-Cell, Diffuse / Proto-Oncogene Proteins c-bcl-2 / Proto-Oncogene Proteins c-bcl-6 / Hypercalcemia Type of study: Prognostic study Limits: Female / Humans Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2017 Type: Article Affiliation country: Chile Institution/Affiliation country: Hospital del Salvador/CL

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Full text: Available Index: LILACS (Americas) Main subject: Translocation, Genetic / Lymphoma, Large B-Cell, Diffuse / Proto-Oncogene Proteins c-bcl-2 / Proto-Oncogene Proteins c-bcl-6 / Hypercalcemia Type of study: Prognostic study Limits: Female / Humans Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2017 Type: Article Affiliation country: Chile Institution/Affiliation country: Hospital del Salvador/CL