{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T10:11:09Z","timestamp":1777716669757,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2012,11,4]],"date-time":"2012-11-04T00:00:00Z","timestamp":1351987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:p>We report a case of a 68-year-old female patient who developed hemophagocytic lymphohistiocytosis (HLH) secondary to peripheral T-cell lymphoma (PTCL) not otherwise specified (NOS) that developed in the setting of treatment-resistant B-cell small lymphocytic lymphoma\/chronic lymphocytic leukemia (SLL\/CLL). The patient\u2019s B-cell lymphoma had a good initial response to chemotherapy for 4 years, after which it became less responsive and was thought to have undergone transition to a higher-grade lymphoma. Different regimens of chemoradiotherapy were then tried with modest response until the patient presented 3 years later with signs and symptoms of HLH. The patient died 1 month later, and an autopsy was performed. Significant para-aortic lymphadenopathy and splenomegaly were found. Microscopic, immunohistochemical and molecular evaluations confirmed the presence of composite B-cell and T-cell lymphoma in the para-aortic enlarged lymph nodes. Bone marrow examination showed hemophagocytosis, and the liver demonstrated infiltration by activated macrophages with hepatocellular necrosis. This report highlights the importance of searching for a possible underlying T-cell lymphoma in light of HLH. Different theories have been proposed to explain the rare occurrence of concurrent B- and T-cell lymphomas, but the development of HLH in this patient highlights the importance of immune dysregulation as a proposed mechanism to explain some cases of composite lymphomas. A review of the literature and discussion of the relative merits of these hypotheses are presented in the context of this case.<\/jats:p>","DOI":"10.1177\/1066896912464047","type":"journal-article","created":{"date-parts":[[2012,11,5]],"date-time":"2012-11-05T22:25:40Z","timestamp":1352154340000},"page":"303-308","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Composite Peripheral T-cell Lymphoma Not Otherwise Specified, and B-cell Small Lymphocytic Lymphoma Presenting With Hemophagocytic Lymphohistiocytosis"],"prefix":"10.1177","volume":"21","author":[{"given":"Ahmed","family":"Alomari","sequence":"first","affiliation":[{"name":"Yale-New Haven Hospital, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Hui","sequence":"additional","affiliation":[{"name":"Yale-New Haven Hospital, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Xu","sequence":"additional","affiliation":[{"name":"Yale-New Haven Hospital, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,11,4]]},"reference":[{"key":"bibr1-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197709)40:3<959::AID-CNCR2820400302>3.0.CO;2-3"},{"key":"bibr2-1066896912464047","doi-asserted-by":"publisher","DOI":"10.5858\/2000-124-1376-AUVOCL"},{"key":"bibr3-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/98.4.424"},{"key":"bibr4-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/103.3.348"},{"key":"bibr5-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199902)60:2<99::AID-AJH3>3.0.CO;2-T"},{"key":"bibr6-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1002\/1096-8652(200103)66:3<203::AID-AJH1045>3.0.CO;2-X"},{"key":"bibr7-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.1190"},{"key":"bibr8-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200407000-00002"},{"key":"bibr9-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2006.10.010"},{"key":"bibr10-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-03-278127"},{"key":"bibr11-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1309\/VD2D-98ME-MB3F-WH34"},{"key":"bibr12-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199209000-00004"},{"key":"bibr13-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-07-2339"},{"key":"bibr14-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V70.1.287.287"},{"key":"bibr15-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2011.02.005"},{"key":"bibr16-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0320(20000615)42:3<188::AID-CYTO5>3.0.CO;2-Q"},{"key":"bibr17-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-009-0390-6"},{"key":"bibr18-1066896912464047","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-10-381921"}],"container-title":["International Journal of Surgical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1066896912464047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1066896912464047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1066896912464047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:19:28Z","timestamp":1777457968000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1066896912464047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,4]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,6]]}},"alternative-id":["10.1177\/1066896912464047"],"URL":"https:\/\/doi.org\/10.1177\/1066896912464047","relation":{},"ISSN":["1066-8969","1940-2465"],"issn-type":[{"value":"1066-8969","type":"print"},{"value":"1940-2465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,4]]}}}