Diffuse large cell lymphoma in a patient with hairy cell leukemia: Immunoglobulin gene analysis reveals separate clonal origins

Academic Article


  • A 75-year-old man with hairy cell leukemia (HCL) was found to have an immunoblastic lymphoma of the small bowel. Immunologic and genotypic characterization of these neoplasms revealed both the HCL and the immunoblastic lymphoma to be of the B cell lineage. The HCL expressed the HCL-associated antigens detected by the monoclonal antibodies HC-1 and HC-2, whereas the immunoblastic lymphoma failed to react with these antibodies. In addition, surface immunoglobulin light chains could not be accurately determined for the hairy cells, whereas the immunoblastic lymphoma was shown to express only κ immunoglobulin light chains. These immunophenotype differences were compatible with either the clonal evolution of the HCL into the immunoblastic lymphoma or a separate clonal origin for these two neoplasms. An analysis of tumor DNA by Southern blot hybridization revealed different heavy-chain and κ light-chain gene rearrangements in these two malignancies. Thus the occurrence of the large cell lymphoma most likely represents the emergence of a second clonally unrelated B cell malignancy.
  • Authors

    Published In

  • Blood  Journal
  • Author List

  • Downing JR; Grossi CE; Smedberg CT; Burrows PD
  • Start Page

  • 739
  • End Page

  • 744
  • Volume

  • 67
  • Issue

  • 3