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Case Rep Med. 2014;2014:620423. doi: 10.1155/2014/620423. Epub 2014 Feb 18.

One Patient, Two Uncommon B-Cell Neoplasms: Solitary Plasmacytoma following Complete Remission from Intravascular Large B-Cell Lymphoma Involving Central Nervous System.

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  • 1Department of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Outram Road, Singapore 169610.
  • 2Department of Pathology, Singapore General Hospital, 11 Jalan Tan Tock Seng, Singapore 169608.
  • 3Department of Pathology, Tan Tock Seng Hospital, Singapore 308433.


Second lymphoid neoplasms are an uncommon but recognized feature of non-Hodgkin's lymphomas, putatively arising secondary to common genetic or environmental risk factors. Previous limited evaluations of clonal relatedness between successive mature B-cell malignancies have yielded mixed results. We describe the case of a man with intravascular large B-cell lymphoma involving the central nervous system who went into clinical remission following immunochemotherapy and brain radiation, only to relapse 2 years later with a plasmacytoma of bone causing cauda equina syndrome. The plasmacytoma stained strongly for the cell cycle regulator cyclin D1 on immunohistochemistry, while the original intravascular large cell lymphoma was negative, a disparity providing no support for clonal identity between the 2 neoplasms. Continued efforts atcataloging and evaluating unique associations of B-cell malignancies are critical to improving understanding of overarching disease biology in B-cell malignancies.

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