A case of diffuse large B-cell lymphoma transformed from immunoglobulin A-producing marginal zone B-cell lymphoma

We present a rare case of diffuse large B-cell lymphoma transformed from im munoglobulin (Ig) A-secreting marginal zone B-cell lymphoma. A 62-year-old woman was admitted to our hospital for examination of a disseminated pulmon ary shadow. Gradual swelling of bilateral axilla and right inguinal lymph n odes were noted after admission. Histological examination of the lymph node biopsy specimen revealed the appearance of marginal zone B-cell lymphoma. The surface Ig of lymphoma cells was IgA-kappa, which coincided with the cl ass of monoclonal Ig found in the patient's serum. The lymph node swelling and pulmonary shadow subsided, and the serum IgA level was normalized by 3 courses of systemic chemotherapy. However, after 4 courses of treatment, ne w tumor lesions at the right chest wall and left arm progressively became a pparent. The biopsy specimen of the tumor showed a feature of diffuse large B-cell lymphoma. Despite intensive chemotherapy, the patient died of sprea ding tumor burden into the central nervous system, Int J Hematol. 2000;72:3 49-352. (C) 2000 The Japanese Society of Hematology.