B-cell lymphoma associated with chronic lymphatic leukaemia: two cases with contrasting aggressive and indolent behaviour

The term Richter's syndrome is used to describe the transformation of chron ic lymphatic leukaemia (CLL) into a high-grade systemic lymphoma and is ass ociated with a poor prognosis. We have undertaken detailed molecular studie s in two patients with cutaneous B-cell lymphoma (CBCL) and CLL, Patient 1 exhibited a low-grade CBCL with different immunoglobulin gene rearrangement s in blood and skin, By contrast, patient 2 showed identical gene rearrange ments, confirmed by gene sequencing, and died within 4 months of presentati on, The latter patient fulfilled the criteria for a diagnosis of cutaneous Richter's syndrome, whereas the former patient demonstrated the coincidence of CLL with a primary CBCL, Our results highlight the importance of gene r earrangement studies with sequencing for the accurate diagnosis of cutaneou s Richter's syndrome.