Potential misdiagnosis of angioimmunoblastic T-cell lymphoma with Hodgkin's lymphoma: a case report.
Potential misdiagnosis of angioimmunoblastic T-cell lymphoma with Hodgkin's lymphoma: a case report.
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发表时间：
2010-09
期刊：
影响因子：
1.8
通讯作者：
J. Laforga;J. M. Gasent;M. Vaquero
中科院分区：
文献类型：
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作者：
J. Laforga;J. M. Gasent;M. Vaquero
血管免疫母细胞性T细胞淋巴瘤（AITL）是一种侵袭性肿瘤。我们研究了触摸印记与淋巴结组织学检查相结合在诊断AITL中的潜在效用。一位58岁的男性，表现为全身性淋巴结病、脾肿大和自身免疫现象，使诊断复杂化。在淋巴结活检中获得了触摸印片，这对正确诊断有价值。这些印记和淋巴结样本的细胞学和显微镜特征显示血淋巴样细胞的异质群体，包括小至中等淋巴样细胞、免疫母细胞、浆细胞、树突状细胞和嗜酸性粒细胞，以及被一些异常细胞包围的小血管。肿瘤细胞CD 3、CD 4和CD 5染色呈阳性。分离的免疫母细胞用CD 20和CD 30染色。结论：我们提请注意这种肿瘤的诊断和相关的细胞形态学和免疫组化结果与适当的临床设置，以避免误诊，主要是霍奇金淋巴瘤和反应性增生。如果广泛的增殖细胞群被区分，则触摸印记在AITL的诊断中是有用的。然而，一些病例显示双核或单核细胞，具有突出的核仁和许多嗜酸性粒细胞，这可能导致与霍奇金淋巴瘤的潜在误诊。
BACKGROUND Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive neoplasm. We investigated the potential utility of touch imprints evaluated in conjunction with the histology of lymph nodes in the diagnosis of AITL. CASE A 58-year-old man presented with generalized lymphadenopathy, splenomegaly, and autoimmune phenomena, which complicated the diagnosis. Touch imprints were obtained from the lymph node biopsy, which were valuable in making the correct diagnosis. The cytologic and microscopic features of these imprints and lymph node samples showed a heterogeneous population of hematolymphoid cells, including small to intermediate lymphoid cells, immunoblasts, plasma cells, dendritic cells, and eosinophils, as well as small vessels that were surrounded by some of the abnormal cells. Neoplastic cells stained positive for CD3, CD4, and CD5. Isolated immunoblasts stained with CD20 and CD30. CONCLUSION We draw attention to this neoplastic diagnosis and correlate the cytomorphologic and immunohistochemical findings with the adequate clinical setting in order to avoid misdiagnosis, primarily with Hodgkin's lymphoma and reactive hyperplasia. Touch imprints are useful in the diagnosis of AITL if the broad population of proliferating cells is distinguished. However, some cases display binucleated or mononucleated cells with prominent nucleoli and many eosinophils, which may induce a potential misdiagnosis with Hodgkin's lymphoma.