Large cell lymphoma complicating acute lymphoblastic leukemia
R Ellerbroek, K Foucar, A Kowal-Vern, JD Kemp, T Kisker, R Tannous and R Strauss
Non-Hodgkin's lymphoma (NHL) is a very rare complication of acute
lymphoblastic leukemia (ALL). We present the pathologic, clinical,
immunologic, and ultrastructural features of the third reported example of
NHL following successfully treated ALL. This white girl developed ALL with
predominantly L1 cells at 3.5 yr of age. The lymphoblasts were terminal
deoxynucleotidyl transferase (TdT) positive and were non-B, non-T cells.
She achieved a complete remission with standard induction therapy and has
remained in continuous complete remission. Four and one- third years after
the onset of ALL, she developed multifocal, pleomorphic large cell lymphoma
of the small bowel, which resulted in episodes of intussusception and
obstruction. These pleomorphic and frequently multinucleated lymphoma cells
lacked TdT, common ALL antigen, and all tested markers of B cell, T cell,
and histiocyte differentiation. Following three small bowel resections,
systemic multiagent chemotherapy, and abdominal irradiation, she is
currently free of disease.
Volume 63,
Issue 4,
pp. 935-939,
04/01/1984
Copyright © 1984 by The American Society of Hematology
