Case report of mediastinal precusor lymphoma with myeloid and lymphoid lineage specific antigens coexpression and translocation t(10;11)(p12;q21)

Abstract

We report a case of 22-year-old female with unusual myeloperoxidase (MPO)-positive and cytoplasmatic (cCD3)- -negative mediastinal precusor lymphoma with myeloid and lymphoid lineage specific antigens coexpression. One week before admission to our institution she was diagnosed with precursor B lymphoblastic lymphoma (B-LBL). Primary diagnosis was based on histopathology (HP) and immunohistochemistry (IH) only, however final diagnosis of terminal deoxynucleotidyl transferase (TdT)-positive lymphoma of myeloid and T-cell lymphoid lineage with translocation t(10;11)(p12;q21) was made by correlation of HP/IH, flow cytometry (FCM), classic cytogenetic analysis and fluorescence in situ hybridization (FISH).Using FISH analysis, we showed, the MLLT 10(AF10) gene rearrangement (locus 10p12) and lack of the CALM (locus 11q14) and MLL (locus 11q23) genes rearrangement, which are considered the most frequent fusions partners of MLLT 10(AF10) gene. Fine needle aspiration biopsy (FNAB) of the mediastinal tumor and pleural fluid was performed by computed tomography (CT) guided procedure in order to obtain cells for a FCM, cytogenetic analysis and FISH.