Adult T-cell lymphoma/leukemia with angioimmunoblastic T-cell lymphornalike features: Report of 11 cases
Adult T-cell lymphoma/leukemia with angioimmunoblastic T-cell lymphornalike features: Report of 11 cases
复制标题
DOI：
10.1097/01.pas.0000213325.79368.2c
复制
发表时间：
2007-02-01
影响因子：
5.6
通讯作者：
Ohshima, Koichi
中科院分区：
文献类型：
--
作者：
Karube, Kennosuke;Suzumiya, Junji;Ohshima, Koichi
在成人T细胞淋巴瘤/白血病(ATLL)中，肿瘤性淋巴样细胞通常是中到大的，通常具有明显的核多形性，与弥漫性多形性外周T细胞淋巴瘤的诊断相一致。我们在这里描述了11例罕见的ATLL的形态变异，血管免疫母细胞性T细胞淋巴瘤(AILT)样型。淋巴结示高内皮微静脉增生，并有浆细胞和嗜酸性粒细胞等多种炎性细胞的存在。淋巴瘤细胞大小不一，胞浆清晰。这些发现提示AILT。但未检测到AILT的免疫组织化学特征，即CD10和CXCL13在淋巴瘤细胞中的表达以及CD21阳性滤泡树突状细胞的增殖。2例CXCR3阳性，9例表达CCR4，通常在ATLL中呈阳性。所有患者的抗成人T细胞白血病/淋巴瘤相关抗原均为阳性，这是一种人类T细胞嗜淋巴病毒I型的特异性抗体。Southern印迹分析显示9例淋巴瘤细胞中有前病毒DNA整合。后者在2例患者的第一次活检中并不明显，但在第一次活检后几个月内获得的第二次活检中显示出明确的前病毒整合。几乎所有患者都表现出积极的临床病程和较差的生存(中位生存期：5个月)。这是首例具有AILT样形态特征的ATLL。
In adult T-cell lymphoma/leukemia (ATLL), the neoplastic lymphoid cells are usually medium-sized to large, often with pronounced nuclear pleomorphism compatible with the diagnosis of diffuse pleomorphic peripheral T-cell lymphoma. We describe here 11 patients with the rare morphologic variant of ATLL, angioimmunoblastic T-cell lymphoma (AILT)-like type. The examined lymph nodes showed proliferation of high endothelial venules and presence of various infiltrating inflammatory cells including plasma cells and eosinophils. The lymphoma cells were medium-to-large size with clear cytoplasm. These findings were suggestive of AILT. However, immunohistochemical features of AILT, namely, CD10 and CXCL13 expression in lymphoma cells and proliferation of CD21-positive follicular dendritic cells, were not detected. Two cases were CXCR3-positive, whereas 9 expressed CCR4, which are usually positive in ATLL. All patients were positive for antiadult T-cell leukemia/lymphoma-associated antigen, which is a specific antibody for human T-cell lymphotropic virus type-I. Southern blot analysis revealed proviral DNA integration in lymphoma cells in 9 patients. The latter was not evident in the first biopsy of 2 patients but in the second biopsy obtained within several months after the first biopsy revealed definite proviral integration. Almost all patients showed aggressive clinical course and poor survival (median survival: 5 mo). This is the first report of ATLL with AILT-like morphologic features.