Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 7994-8002
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7994
Occurrence of MYD88L265P and CD79B mutations in diffuse large b cell lymphoma with bone marrow infiltration: A case report
Wen-Ye Huang, Zhi-Yun Weng
Wen-Ye Huang, Zhi-Yun Weng, Department of Hematology, The Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing 325600, Zhejiang Province, China
Author contributions: Weng ZY provided direction and guidance throughout the preparation of this manuscript and drafted the paper; Huang WY contributed to data analysis; and all authors have read and approved the final manuscript.
Informed consent statement: Written consent was obtained from the patient’s family to participate in the study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read, prepared and revised the manuscript according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Yun Weng, MD, Chief Doctor, Department of Hematology, The Affiliated Yueqing Hospital of Wenzhou Medical University, No. 338 Qingyuan Road, Yueqing 325600, Zhejiang Province, China. weng_zhi_yun@163.com
Received: February 8, 2022
Peer-review started: February 8, 2022
First decision: May 11, 2022
Revised: May 18, 2022
Accepted: June 21, 2022
Article in press: June 21, 2022
Published online: August 6, 2022
Processing time: 163 Days and 18.4 Hours
Abstract
BACKGROUND

Over the past 20 years, we have gained a deep understanding of the biological heterogeneity of diffuse large B cell lymphoma (DLBCL) and have developed a range of new treatment programs based on the characteristics of the disease, bringing us to the era of immune-chemotherapy. However, the effectiveness and molecular mechanisms of targeted-immunotherapy remain unclear in DLBCL. Targeted-immunotherapy may be beneficial for specific subgroups of patients, thus requiring biomarker assessment.

CASE SUMMARY

Here, we report a case of MCD subtype DLBCL with MYD88L265P and CD79B mutations, considered in the initial stage as lymphoplasmic lymphoma (LPL) or Waldenstrom macroglobulinemia (WM). Flow cytometry supported this view; however, the immunohistochemical results of the lymph nodes overturned the above diagnosis, and the patient was eventually diagnosed with MCD subtype DLBCL. The presence of a monoclonal IgM component in the serum and infiltration of small lymphocytes with a phenotype compatible with WM into the bone marrow led us to propose a hypothesis that the case we report may have transformed from LPL/WM.

CONCLUSION

This highlights the possible transformation from WM to DLBCL, CD79B mutation may be a potential biomarker for predicting this conversion.

Keywords: Bone marrow infiltration, Case report, CD79B, Diffuse large B cell lymphoma, Ibrutinib, MYD88L265P

Core Tip: This report highlights the possible transformation from Waldenstrom macroglobulinemia (WM) to diffuse large B cell lymphoma (DLBCL). Bone marrow infiltration by small lymphocytes, with an immunophenotype compatible with WM and the presence of MYD88L265P and CD79B mutations, support the hypothesis that the case may have transformed from lymphoplasmic lymphoma/WM. The CD79B mutation may be a potential biomarker for predicting the conversion of WM to DLBCL. Understanding the biology and mechanisms behind this process is important to identify susceptible patients. Frail patients could benefit from personalized low toxicity therapeutic approaches based on their mutational profile.