Born with Two Faces: Epstein–Barr virus and TET2 in Diffuse Large
B-cell Lymphoma and Angioimmunoblastic T-cell Lymphoma
Abstract
There may be significant histopathological overlap between Epstein–Barr
virus (EBV) -positive diffuse large B cell lymphoma (DLBCL) and other
diagnoses, including angioimmunoblastic T-cell lymphoma (AITL). Herein,
we report a rare case of EBV-positive AITL developing two years after
the initial diagnosis of EBV-positive DLBCL. Histone deacetylase (HDAC)
inhibitor, chidamide, in combination with COEP (cyclophosphamide,
vindesine, etoposide, prednisone) were administrated to treat AITL,
which appeared to prolong the survival of patient. Next-generation
sequencing (NGS) was used to study the possible mechanisms by which this
patient developed AITL after DLBCL. NGS revealed that TET2 mutated in
both DLBCL and AITL. When EBV-positive DLBCL patients with the TET2
mutation, it is necessary to beware of lymphoma recurrence and note that
it may be completely different from the previous type. Our case suggests
that chidamide plus COEP may be a treatment option for AITL after DLBCL
and may prolong patient survival, but this requires a larger sample size
to confirm.