Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7994
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
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.
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 trans
This highlights the possible transformation from WM to DLBCL, CD79B mutation may be a potential biomarker for predicting this conversion.
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.