Search

The case of 70‐year‐old man with mantle cell lymphoma (MCL) carrying t(11;14) translocation that relapsed as nodal lymphoma combining MCL and classic Hodgkin lymphoma (cHL) 9 years after autologous peripheral blood stem cell transplant (auto‐PBSCT) is reported. Lymph nodes contained two separate areas of MCL and cHL‐like components. Hodgkin and Reed–Sternberg (HRS)‐like cells were accompanied by a prominent histiocyte background. HRS‐like cells were CD5−, CD15+, CD20−, CD30+, PAX5+, Bob.1−, Oct2− and EBER+. The MCL component expressed cyclin D1 and SOX11, whereas cyclin D1 and SOX11 expressions were reduced and lost, respectively, in HRS‐like cells. Polymerase chain reaction results showed a single clonal rearrangement of the IGH gene in MCL and cHL‐like components. CCND1 break apart fluorescence in situ hybridization showed split signals in both MCL and HRS‐like cells, suggesting that MCL and cHL‐like components were clonally related. Acquisition of p53 expression and Epstein–Barr virus (EBV)‐positivity was seen in HRS‐like cells. The patient died of disease progression with elevated hepatobiliary enzymes. The autopsy showed both MCL and cHL‐like components around the bile ducts, splenic white pulp and bone marrow. The two components were phenotypically distinct, but genetically related, suggesting that transformation of MCL to HRS‐like cells during the course of MCL in association with EBV infection. [ABSTRACT FROM AUTHOR]

We present three cases of sclerosing mesenteritis and review the literature to learn whether or not sclerosing mesenteritis is an Ig G4-related disease ( Ig G4- RD). Our patients were all adult males. Their mesenteric masses ranged from 6.5 to 14.5 cm in the greatest diameter. Tissue specimens showed moderate to severe lymphoplasmacytic infiltration with occasional eosinophils against a background of irregular fibrosis. Both obliterative phlebitis and storiform fibrosis were noted in all cases. Ig G4+ plasma cells were moderately increased in number (46 to 85 cells/high-power field). However, unlike Ig G4- RD, the Ig G4+/ Ig G+ plasma cell ratio was <40% (28% to 35%). Serum Ig G4 concentrations were also within the normal range (43.2 to 105 mg/dL; normal range <135 mg/dL). Two biopsy cases showed spontaneous regression on imaging approximately 5 months later. No sclerosing conditions were found in other organs. The literature review identified 11 additional cases of sclerosing mesenteritis with Ig G4+ plasma cell infiltration. However, conclusive cases with four characteristic features (high serum Ig G4 levels, tissue Ig G4 elevation, multi-organ involvement, and effective response to glucocorticoid therapy) have never been reported. In conclusion, although sclerosing mesenteritis shares histological features with Ig G4- RD, most cases are less likely to be Ig G4-related. Ig G4- RD seemingly seldom, if ever, affects this anatomical site. [ABSTRACT FROM AUTHOR]