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Cytological and cytogenetic characteristics of highgrade Non-Hodgkin lymphoma with a combination of t(14 ; 18) and c-myc rearrangement

Over the last decade, cytogenetic analysis has become a firmly established technique in the diagnosis and assessment of lymphoid malignancies. Translocations t (14 ; 18) (q32 ; q21) and t (8 ; 14) (q24 ; q32) are cytogenetic hallmarks of follicular and Burkitt lymphoma, respectively. Only rare cases of de novo Burkitt leukaemia/lymphoma (BL) with t (14 ; 18) have been described. In this single center retrospective analysis, we report the results of a cohort of 3 patients with de novo BL characterized by a tandem of t (14 ; 18) and t (8 ; 14) translocation. Patients were 2 females and 1 male, age 59, 51 and 20 at the time of diagnosis. Fine needle aspiration biopsy (FNAB) of enlarged cervical lymph node was performed in all three cases. Giemsa stained FNAB smears were cellular and contained numerous large lymphoid cells with intensively basophilic cytoplasm. Flow kilometric immunophenotyping showed neoplastic B-cells and a diagnosis of Burkett lymphoma was made. In 1/3 patients bone marrow analysis revealed leukemic presentation. Conventional cytogenetics and fluorescence in situ hybridization (FISH) analysis of lymph node showed in all cases the combination of t(14 ; 18) and t(8 ; 14) rearrangement. Despite intensive chemotherapy in 2/3 patients disease progressed and the survival from diagnosis was 2 and 10 months, respectively. One patient underwent autologous stem cell transplantation (2000) and is now pregnant. In conclusion, cytogenetic evaluation of lymph nodes plays a critical role in determining patient management and prognosis. Whether early bone marrow transplant could modify the natural history of the disease remains to be determined.

Cytogenetic analysis; fine needle aspiration; lymph node

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