{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:15:44Z","timestamp":1760242544215},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2012,5,24]],"date-time":"2012-05-24T00:00:00Z","timestamp":1337817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:p>Lymphomas showing both MYC\/8q24 rearrangement and IGH@BCL2\/t(14;18)(q32;q21), also referred to as \u201cdouble\u2010hit\u201d or \u201cdual\u2010hit\u201d lymphomas (DHL) are rare B\u2010cell malignancies with a germinal center B\u2010cell immunophenotype and heterogeneous cytologic and histologic features. Such lymphomas may arise de novo or through transformation of follicular lymphomas and are classified either as \u201cB\u2010cell lymphoma, unclassifiable, with features intermediate between diffuse large B\u2010cell lymphoma (DLBCL) and Burkitt lymphoma (BL)\u201d (most commonly), DLBCL, or, rarely, as B\u2010lymphoblastic lymphoma. We report a case of B\u2010lymphobastic lymphoma arising through transformation of follicular lymphoma diagnosed on peritoneal fluid cytology, flow cytometry, and cytogenetic studies in a 53\u2010year\u2010old man who presented with abdominal pain, shortness of breath, night sweats, extensive lymphadenopathy, pleural effusion, and ascites. Cytologic examination of the ascitic fluid showed two distinct populations of neoplastic lymphoid cells, a predominant population of larger cells with fine powdery (\u201cblastic\u201d) chromatin, visible to prominent nucleoli and occasional small cytoplasmic vacuoles and a less numerous population of smaller cells with centrocytic morphology. Flow cytometry also showed two distinct monotypic B\u2010cell populations, both expressing CD10, and TdT\u2010positivity was demonstrated immunohistochemically. Fluorescence in situ hybridization (FISH) demonstrated both MYC rearrangement and IGH\/BCL2 gene fusion and cytogenetic analysis showed a complex karyotype including both t(14;18)(q32;q21) and t(8;22)(q24.1;q11.2). Since DHL pursue an aggressive clinical course, respond poorly to therapy, and have a poor outcome, it is important to suspect the diagnosis when encountering neoplastic lymphoid cells that are difficult to classify in effusion cytology specimens and to order the appropriate immunophenotyping and cytogenetic studies. Diagn. Cytopathol. 2013;41:986\u2013990. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/dc.22871","type":"journal-article","created":{"date-parts":[[2012,5,24]],"date-time":"2012-05-24T09:46:15Z","timestamp":1337852775000},"page":"986-990","source":"Crossref","is-referenced-by-count":17,"title":["Follicular lymphoma transformed to \u201cdouble\u2010hit\u201d B lymphoblastic lymphoma presenting in the peritoneal fluid"],"prefix":"10.1002","volume":"41","author":[{"given":"Alesia","family":"Kaplan","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arbaz","family":"Samad","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Dolan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adina M.","family":"Cioc","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol J.","family":"Holman","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen C.","family":"Schmechel","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan E.","family":"Pambuccian","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,5,24]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-09-297879"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2011.147"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181cd3aeb"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP7YLDTJPLCE5F"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701836845"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2011.02.006"},{"key":"e_1_2_4_8_1","series-title":"B\u2010cell lymphoma, unclassifiable, with features intermediate between diffuse large B\u2010cell lymphoma and Burkitt lymphoma","first-page":"265","volume-title":"WHO classification of tumours of haematopoietic and lymphoid tissue","author":"Kluin PM","year":"2008"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198805263182106"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.85.22.8548"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/gcc.2870020211"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428199309148200"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1309\/Y2YD-UNA2-C95R-AVM3"},{"key":"e_1_2_4_14_1","doi-asserted-by":"crossref","first-page":"997","DOI":"10.5858\/2002-126-0997-TOFLTA","article-title":"Transformation of follicular lymphoma to acute lymphoblastic leukemia","volume":"126","author":"Sun X","year":"2002","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20156"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20160"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.50.5815"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00125480-200607000-00004"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdc.22871","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.22871","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T17:20:49Z","timestamp":1696612849000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.22871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,24]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1002\/dc.22871"],"URL":"https:\/\/doi.org\/10.1002\/dc.22871","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,24]]}}}