SciELO - Scientific Electronic Library Online

 
vol.145 issue11Austrian syndrome. Report of one casePenetrating ulcer of the ascending aorta treated surgically. Report of two cases author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista médica de Chile

Print version ISSN 0034-9887

Abstract

PENA, Camila; MARTI, María José; VILLEGAS, Pablo  and  UNDURRAGA, María Soledad. 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. Rev. méd. Chile [online]. 2017, vol.145, n.11, pp.1485-1489. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872017001101485.

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.

Keywords : Lymphoma, Large B-Cell, Diffuse; Proto-Oncogene Proteins c-bcl-6; Proto-Oncogene Proteins c- bcl-2.

        · text in Spanish     · Spanish ( pdf )