B-Lymphoblastic Leukemia with BCR::ABL1-like Features After Long-term Lenalidomide Therapy.

Lenalidomide, a derivative of thalidomide, is a type of immunomodulatory drug (IMiD) that has been standard therapy for multiple myeloma (MM) and other hematologic malignancies for almost two decades. The success of these drugs in MM has contributed to increased survival of patients and, as a result, patients are at risk for a secondary primary malignancy (SPM), some of which occur as a result of treatment for MM. MM patients have an increased risk for acute myeloid leukemia (AML) and Kaposi sarcoma.

Perifollicular concentric granulomas: A clue to IgG4-related lymphadenopathy.

A 69-year-old with well-controlled HIV was evaluated for persistent cough, in the context of years of fatigue and influenza A infection 6 months prior. Chest CT and PET scans were notable for adenopathy concerning for a lymphoproliferative disorder. Radiologic studies also showed diffuse FDG uptake in the prostate, consistent with prostatitis.

Pediatric Myelodysplastic Syndrome with SF3B1 Mutation.

Patients with Fanconi Anemia (FA) have an increased risk of developing myeloid malignancies, which often precede the diagnosis of FA. We describe a patient with non-specific clinical findings diagnosed with myelodysplastic syndrome (MDS) at 17 years of age. A pathogenic SF3B1 alteration was identified and prompted evaluation for a bone marrow failure syndrome.