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FIGURE 1 A, Magnetic resonance T2-weighted imaging of the head. The tumor occupied the right external acoustic meatus, tympanic cavity, mastoid cells, and internal acoustic meatus with invasion into the right temporal muscle (arrow). B, Contrast-enhanced abdominal computed tomography. The kidneys were bilaterally enlarged with poorly enhanced lesions. C–F, Histopathologic findings of the tumor tissue. C, Hematoxylin and eosin staining. Infiltration of medium- to large-sized centroblasts. D, Immunohistochemical staining for MIB-1. The MIB-1 proliferation index was 80–90%. E and F, Immunohistochemical staining for CD20 (E) and BCL2 (F). The centroblasts were positive for CD10, CD20, CD79a, and BCL2 and negative for CD3, CD5, terminal deoxynucleotidyl transferase, and Epstein-Barr virus-encoded small RNAin situ hybridization.
FIGURE 2 A, DNA, mRNA, and protein conformation of theKMT2A -MLLT3 fusion. MBM, MENIN-binding motif; IBM, integrase domain-binding motif; zf, zinc finger; AHD, ANC1 homology domain. B, Sanger sequencing showing the fusion between exon 9 ofKMT2A and exon 6 of MLLT3 . C, t-SNE plot generated using the RNA-seq data from the patient and patients with DLBCL andKMT2A -rearranged ALL obtained from published studies.11,12
SUPPLEMENTAL TABLE S1 Primer sequences for reverse transcription-polymerase chain reaction.