Advertisement

Journal of Hematopathology

, Volume 11, Issue 4, pp 115–118 | Cite as

Primary spinal T cell/histiocyte-rich large B cell lymphoma (THRLBCL)—a rare diagnosis at a rare site

  • Rachna KheraEmail author
  • Faiq Ahmed
  • Sudha S. Murthy
  • Venkateswara Rao
  • Krishna Mohan Mallavarapu
  • Sundaram Challa
Case Report
  • 27 Downloads

Abstract

T cell/histiocyte-rich large B cell lymphoma (THRLBCL) is an unusual variant of diffuse large B cell lymphoma with poor prognosis. We describe a case of THRLBCL with an uncommon isolated spinal involvement. A 37-year-old male came to the neurosurgery outpatient department with weakness of both upper and lower limbs. Histopathology and immunohistochemistry revealed features consistent with THRLBCL. The patient was treated with D5-D6 laminectomy followed by six cycles of chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin, prednisolone) and was disease free for 5 years until he had relapse of disease at the same location in 2016 for which he is receiving palliative radiation therapy. Isolated spinal involvement as the first or only manifestation of THRLBCL is very rare and has been described very occasionally in the literature. It is important to correctly diagnose this entity and differentiate it from its mimics because of different prognostic and therapeutic implications.

Keywords

Spine THRLBCL PCNSL DLBCL 

Notes

Compliance with ethical standards

The manuscript is compliant with ethical standards.

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Schlegel U (2009) Primary CNS lymphoma. Ther Adv Neurol Disord 2(2):93–104CrossRefGoogle Scholar
  2. 2.
    Machiya T, Yoshita M, Iwasa K, Yamada M (2007) Primary spinal intramedullary lymphoma mimicking ependymoma. Neurology 68:872CrossRefGoogle Scholar
  3. 3.
    Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rudolph C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B, Rübe C, Loeffler M, German High-Grade Non-Hodgkin’s Lymphoma Study Group (2004) Two-weekly of 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood 104(3):626–633CrossRefGoogle Scholar
  4. 4.
    Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of tumours of haematopoietic and lymphoid tissues 4th ed. Lyon, France: International Agency for Research on Cancer 2008Google Scholar
  5. 5.
    Jaffe ES, Longo DL, Coasman J et al (1984) Diffuse large B-cell lymphoma with T-cell predominance in patients with follicular lymphoma or “pseudo T-cell lymphoma”. Lab Investig 27A:50Google Scholar
  6. 6.
    Muzaffar SL, Soomro IN, Kayani N, Siddiqui S, Husein YA, Jooma R (1998) Primary spinal T-cell rich B-cell lymphoma: a case report. J Pak Med Assoc 48(5):148–149PubMedGoogle Scholar
  7. 7.
    Weshi AE, Akhtar S, Mourad WA, Ajarim D, Abdelsalm M, Khafaga Y et al (2007) T-cell/histiocyte-rich B-cell lymphoma: clinical presentation, management and prognostic factors: report on 61 patients and review of literature. Leuk Lymphoma 48:1764–1773CrossRefGoogle Scholar
  8. 8.
    Lim MS, Beaty M, Sorbara L, Cheng RZ, Pittaluga S, Raffeld M, Jaffe ES (2002 Nov) T-cell/histiocyte-rich large B-cell lymphoma: a heterogeneous entity with derivation from germinal center B cells. Am J Surg Pathol 26(11):1458–1466CrossRefGoogle Scholar
  9. 9.
    Koeller KK, Smirniotopoulos JG, Jones RV (1997) Primary central nervous system lymphoma: radiologic-pathologic correlation. RadioGraphics 17:497–1526CrossRefGoogle Scholar
  10. 10.
    Carra BJ, Sherman PM (2013) Intradural spinal neoplasms: a case based review. J Am Osteopath Coll Radiol 2(3):13–21Google Scholar
  11. 11.
    Fan Z, Natkunam Y, Bair E, Tibshirani R, Warnke RA (2003) Characterization of variant patterns of nodular lymphocyte predominant Hodgkin lymphoma with immunohistologic and clinical correlation. Am J Surg Pathol 27(10):1346–1356CrossRefGoogle Scholar
  12. 12.
    Mourad WA, Al Thani S, Tbakhi A, Al Omari M, Khafaga Y, Shoukri M, El Weshi A, Al Shabana M, Ezzat A (2008) Morphologic, immunphenotypic and clinical discriminators between T-cell/histiocyte-rich large B-cell lymphoma and lymphocyte-predominant Hodgkin lymphoma. Hematol Oncol Stem Cell Ther 1(1):22–27CrossRefGoogle Scholar
  13. 13.
    Kunder C, Cascio MJ, Bakke A, Venkataraman G, O’Malley DP, Ohgami RS (2017 Jun 1) Predominance of CD4+ T cells in T-cell/Histiocyte-rich large B-cell lymphoma and identification of a subset of patients with peripheral B-cell lymphopenia. Am J Clin Pathol 147(6):596–603CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Laboratory MedicineBasavatarakam Indo-American Cancer Hospital and Research InstituteHyderabadIndia
  2. 2.Department of NeurosurgeryBasavatarakam Indo-American Cancer Hospital and Research InstituteHyderabadIndia
  3. 3.Department of Medical OncologyBasavatarakam Indo-American Cancer Hospital and Research InstituteHyderabadIndia

Personalised recommendations