{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:25:54Z","timestamp":1745468754249,"version":"3.40.4"},"reference-count":17,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>Lymphomas are presently categorized according to their origin from B or T lymphocytes. The co-expression of CD3 in B-cell lymphomas or CD20 in T-cell lymphomas has been rarely reported. Immature and less often mature lymphomas may incorporate the rearrangements of both B- and T-cell antigen receptor genes (dual genotype or bigenotype). Lymphoma cells with a sole genotype hardly concurrently express both B- and T-cell markers (biphenotypic lymphomas). We describe a 63-year-old female who was presented with obstructive jaundice and epigastric pain of 10 days. Initial CBC revealed 43x10&lt;sup&gt;3&lt;\/sup&gt;\/\u03bcL white blood cells, 11.2 g\/dL hemoglobin, and 88x10&lt;sup&gt;3&lt;\/sup&gt;\/\u03bcL platelets. CT abdomen revealed hepatomegaly and suspected pancreatic mass with large retroperitoneal lymph nodal mass. Peripheral smear showed 56% lymphoid cells with blast morphology. The bone marrow (BM) aspirate smear was infiltrated by 83% immature-looking cells. BM biopsy showed interstitial to diffuse extensive infiltration by primitive-looking cells, positive for pan-B-cell antigens CD20, CD79, and PAX5 as well as the T-cell antigen CD4, CD5, CD3, while negative for all immaturity markers (CD34, TdT, and CD1a). In situ hybridization for Epstein-Barr virus (EBV)-encoded small RNA (EBER) was negative. Flow cytometry on BM aspirate showed an abnormal population (50%) expressing the B-cell antigens (CD19, CD20, CD79, CD22) and CD10, and showed lambda light chain restriction as well as the T-cell antigens cCD3 and CD4 with partial CD5. The analysis showed, also, another abnormal population of lambda restricted monotypic B cells (8%) with dimmer CD45 (blast gate) and showed the same immunophenotype (expressing the B-cell antigens), but negative for CD10, cCD3, CD5, and CD4. Conventional cytogenetic revealed complex karyotype. Molecular studies revealed rearrangements of the immunoglobulin heavy chain region consistent with a clonal B-cell population. TCR gene rearrangement analysis was equivocal concerning clonality but was not conclusive for clonal T-cell disease. Our final diagnosis was peripheral blood and BM involvement by EBV-negative high-grade lymphoid neoplasm (in leukemic phase with blast morphology) and an ambiguous immunophenotype with a differential diagnosis that may include the rare entity of bigenotypic lymphoma or an unusual case of high-grade B-cell lymphoma with aberrant expression of T-cell markers (biphenotypic lymphomas). <\/jats:p>","DOI":"10.1159\/000510403","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T21:00:37Z","timestamp":1601499637000},"page":"1215-1226","source":"Crossref","is-referenced-by-count":2,"title":["High-Grade Epstein-Barr Virus-Negative Biphenotypic Lymphoma with Expression of B- and T-Cell Markers and Leukemia Presentation: Case Report and Literature Review"],"prefix":"10.1159","volume":"13","author":[{"given":"Samah","family":"Kohla","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feryal A.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deena","family":"Mudawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Akiki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Soliman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Al-Sabbagh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reda R.H.","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Yassin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2020,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.5045\/br.2013.48.2.156"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318185d231"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/path.1192"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404479"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2007.00882.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20163"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3816\/CLM.2009.n.033"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880035"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.iy.06.040188.003213"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-016-2749-0"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2007.00882.x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31825e63a9"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0b013e328340bbba"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200206000-00005"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0134833"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0136086"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/nature06159"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/510403","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/510403","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:55:59Z","timestamp":1745423759000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000510403"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,30]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,1,6]]}},"URL":"https:\/\/doi.org\/10.1159\/000510403","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.13026206","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"type":"electronic","value":"1662-6575"}],"subject":[],"published":{"date-parts":[[2020,9,30]]}}}