Journal
BLOOD
Volume 100, Issue 7, Pages 2659-2661Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2002-01-0169
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Tumors of the splenic marginal zone can present In spleen or blood. The maturational status of the neoplastic B cells from each site appears heterogeneous, with either unmutated or mutated variable-region heavy chain (V-H) genes. To determine an influence of tissue location, we assessed matched blood and splenic tumor cells from 4 patients and found them Identical. However, one patient with unmutated V-H genes in blood and spleen developed a clonally related diffuse large B-cell lymphoma in the chest wall. Strikingly, this subclone had undergone significant somatic mutation, with clear intracional heterogeneity. To our knowledge, this Is the first case of a B-cell tumor showing initiation of somatic mutation in vivo. The finding emphasizes that the tissue micro-environment can influence tumor cell behavior and possibly affect disease progression. Importantly, because several replacement mutations were located within or close to the complementarity-determining regions (CDRs), it raises the question of a role for antigen in driving tumor growth. (C) 2002 by The American Society of Hematology.
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