Case Report

T-Cell B-Rich Lymphoma Presenting as Renal Colic with Positivity of CD3

Abstract

T-Cell Rich B-Cell Lymphoma (TCRBCL) is relatively a new entity, lately classified as a morphologic variant of Diffuse Large B-cell lymphomas (DLBCL). It consists (1-3) % of all B-cell lymphomas. The rate is far less when describing cases of primary splenic involvement with TCRBCL. Pathologically, TCRBCL is described as a limited number of scattered, large, atypical b-cells embedded in a background of abundant t-cells and frequently histiocytes. The similarity of this malignancy with other types makes it difficult to distinguish between them. Thus, it needs expertise in both clinical and pathological fields to make the right diagnosis.
Here, we present a case of an adult male patient whose first presentation and previous medical history of renal colic misguided the initial diagnosis and suggested another colic episode as the underlying ailment. However, further physical, radiological and histopathological investigations uncovered the presence of primary TCRBCL within spleen with no involvement of other sites. Moreover, unusual pathologic finding of CD3 positivity was proved by immunohistochemistry.

1. Ramsay AD, Isaacson PG. T-Cell-Rich B-Cell Lymphoma. Am J Surg Pathol. 1988; 12(6):433-443.
2. Jaffe ES. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues2001.
3. Swerdlow SH, Campo E, Harris NL, et al, WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Fourth Edition ed2008.
4. J. Cornillie TT, G. Verhoef. T-cell/histiocyte-rich large B-cell lymphoma: review on pathologic diagnosis,current therapeutic options and new targets for therapy. BJH. 2012; 3(4):128-33.
5. Grosskreutz C, Troy K, Cuttner J. Primary splenic lymphoma: report of 10 cases using the REAL classification. Cancer invest. 2002; 20(5-6):749-53.
6. Tousseyn T, De Wolf-Peeters C. T cell/histiocyte-rich large B-cell lymphoma: an update on its biology and classification. Virchows Arch. 2011; 459(6):557-63.
7. Spier CM, Kjeldsberg CR, Eyre HJ, et al. Malignant lymphoma with primary presentation in the spleen. A study of 20 patients. Arch Pathol Lab Med. 1985; 109(12):1076-80.
8. Kaza RK, Azar S, Al-Hawary MM, et al. Primary and secondary neoplasms of the spleen. Cancer Imaging. 2010; 10: 173-82.
9. Delabie J, Vandenberghe E, Kennes C, et al. Histiocyte-rich B-cell lymphoma. A distinct clinicopathologic entity possibly related to lymphocyte predominant Hodgkin's disease, paragranuloma subtype. Am J Surg Pathol. 1992; 16(1):37-48.
10. Armitage JO, Weisenburger DD. New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project. J Clin Oncol. 1998; 16(8):2780-95.
11. Aki H, Tuzuner N, Ongoren S, et al. T-cell-rich B-cell lymphoma: a clinicopathologic study of 21 cases and comparison with 43 cases of diffuse large B-cell lymphoma. Leuk Res. 2004; 28(3):229-36.
12. Abramson JS. T-cell/histiocyte-rich B-cell lymphoma: biology, diagnosis, and management. Oncologist. 2006; 11(4):384-92.
13. Greer JP, Macon WR, Lamar RE, et al. T-cell-rich B-cell lymphomas: diagnosis and response to therapy of 44 patients. J Clin Oncol. 1995; 13(7):1742-50.
14. Rüdiger T, Jaffe ES, Delsol G, et al. Workshop report on Hodgkin's disease and related diseases ('grey zone' lymphoma). Ann Oncol.
Files
IssueVol 13, No 1 (2019) QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/ijhoscr.v13i1.318
Keywords
T-cell-rich B-cell lymphoma; B-cell lymphoma; TCRBCL; Renal colic
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Al Houri H, Ahmad T, Zaher Adden S, Assad W, Raiy A. T-Cell B-Rich Lymphoma Presenting as Renal Colic with Positivity of CD3. Int J Hematol Oncol Stem Cell Res. 2019;13(1):2-6.