Multiple lymphoid nodules in bone marrow have the same clonality as underlying myelodysplastic syndrome recognized with fluorescent in situ hybridization technique

Benign nodular lymphoid lesions are not rare in the bone marrow of patients with myelodysplastic syndrome (MDS). Herein, we report a case of MDS with clonal lymphoid aggregates in the bone marrow but without evidence of systemic lymphoma. The case of a 71‐year‐old man was evaluated for cytopenia. Hi...

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Bibliographic Details
Published in:American journal of hematology 1998-11, Vol.59 (3), p.252-257
Main Authors: Mongkonsritragoon, Wichean, Letendre, Louis, Li, Chin‐Yang
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blotting, Southern
Bone Marrow Cells - pathology
Centromere
Clone Cells - pathology
Hematologic and hematopoietic diseases
Humans
Immunohistochemistry
in situ hybridization
In Situ Hybridization, Fluorescence
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
lymphoid nodule
Lymphoid Tissue - pathology
Male
Medical sciences
myelodysplastic syndrome (MDS)
Myelodysplastic Syndromes - genetics
Myelodysplastic Syndromes - pathology
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Summary:Benign nodular lymphoid lesions are not rare in the bone marrow of patients with myelodysplastic syndrome (MDS). Herein, we report a case of MDS with clonal lymphoid aggregates in the bone marrow but without evidence of systemic lymphoma. The case of a 71‐year‐old man was evaluated for cytopenia. His bone marrow was initially hypocellular, with 10% blasts and a few small lymphoid aggregates. The diagnosis of refractory anemia with excess blasts was made. The disease progressed gradually, and he received erythropoietin and granulocyte colony‐stimulating factor for a short time. Forty‐two months later, acute leukemia (M1) developed, with 60% to 70% blasts in the bone marrow. The bone marrow also showed large aggregates of lymphocytes. Immunohistochemical study of these cells in the nodular lesions showed 50% CD3+ and 50% CD20+. Cytogenetic and molecular genetic studies revealed monosomy 7 and T‐ and B‐cell clonal gene rearrangement. Fluorescent in situ hybridization study with centromere‐specific probes of a bone marrow specimen showed monosomy 7 in both nodular lymphoid lesions and surrounding bone marrow cells, indicating that both processes originated from the same abnormal pluripotential progenitor. Am. J. Hematol. 59:252–257, 1998. © 1998 Wiley‐Liss, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/(SICI)1096-8652(199811)59:3<252::AID-AJH14>3.0.CO;2-C