Clonally unrelated primary large B‐cell lymphomas separated by over a decade involving the central nervous system and testicle: Possible predisposition to lymphomas of immune‐privileged sites?
Giby V. George,
Diana G. Aldowitz,
Audrey N. Jajosky,
Danielle S. Wallace,
W. Richard Burack,
Jonathan W. Friedberg,
Siba El Hussein
Affiliations
Giby V. George
Department of Pathology and Laboratory Medicine University of Rochester Medical Center Rochester New York USA
Diana G. Aldowitz
Department of Pathology and Laboratory Medicine University of Rochester Medical Center Rochester New York USA
Audrey N. Jajosky
Department of Pathology and Laboratory Medicine University of Rochester Medical Center Rochester New York USA
Danielle S. Wallace
Wilmot Cancer Institute University of Rochester Medical Center Rochester New York USA
W. Richard Burack
Department of Pathology and Laboratory Medicine University of Rochester Medical Center Rochester New York USA
Jonathan W. Friedberg
Wilmot Cancer Institute University of Rochester Medical Center Rochester New York USA
Siba El Hussein
Department of Pathology The University of Vermont Larner College of Medicine Burlington Vermont USA
Abstract Primary large B‐cell lymphomas of immune‐privileged sites (IP‐LBCLs) comprise LBCLs arising within “immune sanctuaries,” including the central nervous system (CNS), vitreoretina, and testes. Although patients present with localized disease, the prognosis remains poor with high relapse rates, either at the originating site or within another immune‐privileged site. Generally, in the presence of an antecedent IP‐LBCL, subsequent LBCLs are expected to be clonally related. However, we present a primary CNS LBCL and later primary testicular LBCL in a middle‐aged man, diagnosed over a decade apart, which proved to be clonally unrelated by targeted ultra‐deep next‐generation sequencing of the IgH locus.
