Rare 2p Gain with Complex Karyotype in a Symptomatic Patient with Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia

Farhan Khan, Rabia Zafar, Lori Wilson and Tammey Naab

Department of Pathology, Howard University, USA
Department of Surgery, Howard University, USA

^*Correspondance to: Tammey Naab 

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Abstract:

Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) is often an incidental finding in an elderly asymptomatic patient. We report a case of a 58 year old female, presenting with fever, night sweats and painless submandibular and supraclavicular lymphadenopathy. The left axillary lymph node excisional biopsy showed complete effacement of architecture by small mature lymphocytes. There were scattered pseudofollicles with pale nodular appearance containing large lymphocytes with open chromatin. The neoplastic cells were small with round nuclear contours, coarsely clumped chromatin and scant cytoplasm and they diffusely expressed CD20, CD5 and CD23 consistent with SLL/CLL. Ki-67 (20%) was increased outside of the proliferation centers. Flow cytometry revealed a clonal kappa population with coexpression of CD20, CD5 and CD23. Karyotyping revealed a complex abnormal karyotype with two neoplastic clones and several rearrangements, including a gain of 2p resulting from der (14) t (2;14), confirmed by concurrent FISH showing a MYCN (2p24) signal in the der (14). CLL with 2p gain is usually associated with unfavorable cytogenetic deletions (11q, 17p), unmutated status of immunoglobulin heavy chain (IGHV) and increased CD38. However, in our case, FISH showed loss of 13q and CD38 was low (5%), findings more often associated with a favorable prognosis.

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Cite the Article:

Khan F, Zafar R, Wilson L, Naab T. Rare 2p Gain with Complex Karyotype in a Symptomatic Patient with Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia. Ann Clin Case Rep. 2017; 2: 1448.