The utility of B-cell receptor gene rearrangement studies in diagnosing diffuse large B-cell lymphoma with plasmacytic differentiation

Ann Clin Lab Sci. 2015 Winter;45(1):79-82.


We present the case of a 50-year-old man with nodal diffuse large B-cell lymphoma characterized by CD10, BCL-6, and BCL-2 expression and a complex karyotype, including t(14;18)(q32;q21) and del6q, suggesting transformation from an antecedent follicular lymphoma. Following rituximab-based chemotherapy, residual nodal disease was characterized by a proliferation of plasmacytoid cells positive for CD138, MUM-1, and cytoplasmic kappa light chain. Immunoglobulin heavy chain and kappa light chain gene rearrangement studies detected the same clone in the diagnostic and post-therapy lymph node specimens. This case illustrates the diagnostic utility of B-cell receptor gene rearrangement studies in detecting a clonal relationship in lymphoma cases with extensive morphologic and immunophenotypic variation following chemotherapy.

Keywords: B cell receptor gene rearrangement; Diffuse large B cell lymphoma; plasmacytic differentiation.

Publication types

  • Case Reports

MeSH terms

  • Cell Differentiation*
  • Gene Rearrangement, B-Lymphocyte*
  • Humans
  • Lymph Nodes / pathology
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / genetics*
  • Male
  • Middle Aged
  • Plasma Cells / pathology*
  • Polymerase Chain Reaction
  • Receptors, Antigen, B-Cell / genetics*
  • V(D)J Recombination / genetics


  • Receptors, Antigen, B-Cell