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A case of AL amyloidosis associated with follicular lymphoma with plasmacytic differentiation

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Abstract

A 58-year-old woman underwent emergency surgical resection of the small intestine for intussusception as diagnosed at our hospital. Histopathological diagnosis of the resected specimen of the ileum was amyloid light chain (AL) amyloidosis. The colonoscopy after the surgical resection and following histopathological analysis of the biopsied specimens of the colon revealed follicular lymphoma (FL) grade 1 with plasmacytic differentiation. Histological findings of these ileal and colonic lesions were characteristic. In the ileum, CD10-positive lymphoid follicles and CD38-positive interfollicular plasma cell infiltration into villi were detected. The amyloid deposition was localized to the ileum and was adjacent to lymphoid follicles and interfollicular plasma cells. Furthermore, fluorescence in situ hybridization (FISH) for paraffin-embedded tissue sections (tissue-FISH) revealed that both the B cells in follicular lesions and the interfollicular plasma cells showed IGH/BCL2 fusion signals, which means the interfollicular plasma cells were originated from the differentiated neoplastic follicular B cells. The patient was treated with six courses of lymphoma chemotherapy and attained complete remission without any symptoms associated with amyloidosis. Further case analyses are needed to clarify the clinicopathological findings and to establish therapeutic strategy of AL amyloidosis associated with FL and FL with plasmacytic differentiation.

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, Kyoto, 605-8981, Japan

    Yosuke Matsumoto

  2. Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan

    Yosuke Matsumoto, Mihoko Yoshida, Kazuho Shimura, Hiroto Kaneko & Masafumi Taniwaki

  3. Department of Laboratory Medicine, Aiseikai Yamashina Hospital, Kyoto, Japan

    Yosuke Matsumoto, Tetsuya Masuda & Masafumi Taniwaki

  4. Department of Surgical Pathology, Aiseikai Yamashina Hospital, Kyoto, Japan

    Ayako Nishimura

  5. Department of Gastoroenterology, Aiseikai Yamashina Hospital, Kyoto, Japan

    Hideki Horie

  6. Department of Surgery, Aiseikai Yamashina Hospital, Kyoto, Japan

    Kenichi Harada

  7. Center for Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Masafumi Taniwaki

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  1. Yosuke Matsumoto
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  2. Tetsuya Masuda
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Correspondence to Yosuke Matsumoto.

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Matsumoto, Y., Masuda, T., Nishimura, A. et al. A case of AL amyloidosis associated with follicular lymphoma with plasmacytic differentiation. Int J Hematol 111, 317–323 (2020). https://doi.org/10.1007/s12185-019-02734-7

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  • DOI: https://doi.org/10.1007/s12185-019-02734-7

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