Primary Bone Marrow T-cell Anaplastic Large Cell Lymphoma with Triple M Gradient

Árpád SZOMOR1, Talal AL SAATI4, Georges DELSOL4, László KERESKAI2, Zsuzsanna SZIJÁRTÓ3, Hajna LOSONCZY1

11st Department of Medicine, University of Pécs, Pécs, Hungary
2Institute of Pathology, University of Pécs, Pécs, Hungary
3Department of Ophthalmology, University of Pécs, Pécs, Hungary
4Laboratory of Anatomic Pathology, Central Hospital University Purpan, Toulouse, France


We present a case of a 60-year-old male patient with primary bone marrow anaplastic large cell lymphoma. He was admitted to the hospital with the symptoms of anemia and fever. There was no evidence of lymphadenopathy or splenomegaly. Immunoelectrophoresis showed the presence of a triple M gradient (double IgM and an IgG), with the IgG and one of the IgM paraproteins functioning as a cryoglobulin. The patient had no hepatitis C virus infection. Bone marrow biopsy showed massive CD30-positive, ALK-negative large lymphoid cell infiltration of T-cell origin with anaplastic morphology. PCR analysis of lymphoid cells separated from the bone marrow demonstrated the presence of a B/T hybrid genotype disorder with no evidence of the t(2;5), nor t(1;2) translocations. The patient entered a period of remission following CHOP chemotherapy. The patient subsequently died of sepsis as a consequence of serious humoral immunodeficiency. Pathology & Oncology Research, Vol 13, Nr 3, 260-262, 2007

Key words: anaplastic large cell lymphoma; T-cell receptor gene rearrangement; immunoglobulin heavy chain gene rearrangement; M gradient; bone marrow

Received: Nov 15, 2006; accepted: Jul 15, 2007
Correspondence: Árpád SZOMOR, 1st Department of Medicine, University of Pécs, Ifjúság u. 13. Pécs H-7624, Hungary; Tel: 00-36-72-536000/1323, Fax: 00-36-72-536148; E-mail:

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