Erschienen in:
06.07.2021 | Brief Report
Transdifferentiation of mantle cell lymphoma into sarcoma with limited neuromuscular differentiation after conventional chemotherapy
verfasst von:
Ichiro Kawashima, Naoki Oishi, Kazunari Kasai, Tomohiro Inoue, Eriko Hosokawa, Ayato Nakadate, Minori Matsuura, Takuma Kumagai, Megumi Koshiishi, Takeo Yamamoto, Kei Nakajima, Masaru Tanaka, Tetsuo Kondo, Keita Kirito
Erschienen in:
Virchows Archiv
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Ausgabe 5/2022
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Abstract
We report an exceptionally rare case of mantle cell lymphoma (MCL) that transdifferentiated into sarcoma with limited neuromuscular differentiation. An 81-year-old man with t(11;14)-positive MCL was treated with rituximab and bendamustine and achieved complete remission; however, just 2 months later, the patient developed multiple systemic tumors. Pathologic studies revealed round cell sarcoma expressing synaptophysin, CD56, and myogenin without any B-cell markers. The CCND1 translocation and an identical IGL gene rearrangement were shared by both the MCL and sarcoma. Whole-exome sequencing detected 189 single nucleotide variants (SNVs) in the MCL and 205 SNVs in the sarcoma; 160 SNVs including NSD2, ATM, RB1, and TP53 mutations were shared between MCL and sarcoma cells. An additional PTPN11 mutation was specifically found in the sarcoma. These findings confirmed the shared clonal origin of MCL and sarcoma in this patient and indicated that MCL can transdifferentiate into sarcoma in rare cases.