AUTHOR=Zhang Bing , Zhang Yangyang , Li Quan , Jiang Qingjun , Chu Wei , Gong Haifeng , Li Ruyuan , Ji Hong 

TITLE=Case report: Chronic lymphocytic leukemia/small lymphocytic lymphoma and monomorphic epitheliotropic intestinal T-cell lymphoma: A composite lymphoma

JOURNAL=Pathology and Oncology Research

VOLUME=28

YEAR=2022

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2022.1610653

DOI=10.3389/pore.2022.1610653

ISSN=1532-2807

ABSTRACT=<p><bold>Background:</bold> Composite lymphomas involving B-cell and T-cell lymphomas is very rare.</p><p><bold>Case presentation:</bold> We reported a 63-year-old gentleman with composite chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). The patient was admitted to our hospital due to abdominal pain, and was diagnosed with CLL/SLL after bone marrow (BM) biopsy, BM aspiration, and flow cytometry. Two weeks later, he was diagnosed with MEITL based on pathological analysis after intestine excision. Next gene sequencing (NGS) findings identified two hotspot mutation sites (<italic>STAT5B</italic> and <italic>DNMT3A</italic>) closely related with the pathogenesis of CLL/SLL and MEILT. Additionally, <italic>BCOR</italic> mutation was only detected in the CLL/SLL area. The likely pathogenic mutations of CLL were <italic>SETD2</italic>, <italic>NOTCH1</italic>, <italic>SF3B1</italic>, and <italic>PTPN11</italic>, while the likely pathogenic mutations related with the MEILT were <italic>TET2</italic> and <italic>ZRSR2</italic>. Mutations of <italic>GATA3</italic>, <italic>PLCG2</italic>, and <italic>FAT1</italic> were identified in both CLL/SLL and MEITL areas, but the clinical significance was unknown. Finally, the patient died in the 12-month follow-up after surgery.</p><p><bold>Conclusion:</bold> We report a rare case of composite CLL/SLL and MEITL that highlights the importance of careful inspection of hematologic neoplasms. We also present the results of NGS of different gene mutations in CLL and MEITL tissues.</p>