Clinical and cytopathological characteristics of HTLV-1(+) Hodgkin lymphoma.
Clinical and cytopathological characteristics of HTLV-1(+) Hodgkin lymphoma.
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HTLV-1( )霍奇金淋巴瘤的临床和细胞病理学特征。
DOI：
10.1002/cam4.3139
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发表时间：
2020
期刊：
影响因子：
4
通讯作者：
Takeshita M.
中科院分区：
文献类型：
--
作者：
Kobata K;Kimura S;Mihashi Y;Iwasaki H;Nonaka S;Matsumoto S;Takamatsu Y;Choi I;Kawauchi S;Ishitsuka K;Takeshita M.
背景人类T淋巴细胞病毒-1（HTLV-1）+霍奇金淋巴瘤（HL）与具有HL样组织学的成人T细胞白血病/淋巴瘤（ATLL）很难鉴别方法细胞学和免疫组织学特征，HTLV-1前病毒DNA整合，在11例HTLV-1+ HL样疾病患者中检测了T细胞受体（TCR）Cβ 1基因重排。根据HTLV-1前病毒DNA整合和TCRCβ 1基因重排的遗传学发现，HL和5例HL样ATLL。在6例HTLV-1+HL患者的背景中检测到具有圆形核的小型普通淋巴细胞，其对CD 25和CC趋化因子受体（CCR）4呈化学阴性，并且具有低MIB 1标记指数（平均值：28.3%）。在HL样ATLL标本中，发现了具有锯齿状和不规则形状核的小型和中型非典型淋巴细胞，并且CD 25和CCR 4呈弥漫性阳性，MIB 1标记较高（平均值：76%）。两组均有散在的CD 30+和CD 15+霍奇金和里德斯滕贝格（RS）巨细胞，伴或不伴CD 20表达和Epstein巴尔病毒感染。HTLV-1+HL组的50%总生存期（180个月）显著长于HL样ATLL组（7.8个月;P= .004）。结论HTLV-1+HL在霍奇金淋巴瘤和RS细胞背景中表现出典型的小淋巴细胞，MIB 1标记指数较低，有一些分散的CD 25+和CCR 4+淋巴细胞。在HTLV-1流行地区，区分HTLV-1+HL与HL样ATLL很重要，因为它们的治疗策略和治疗方法不同。
BackgroundHuman T‐lymphotropic virus‐1 (HTLV‐1)+Hodgkin lymphoma (HL) is difficult to differentiate from adult T‐cell leukemia/lymphoma (ATLL) with HL‐like histology (HL‐like ATLL).MethodsCytological and immunohistological features, HTLV‐1 proviral DNA integration, and rearrangements of the T‐cell receptor (TCR)Cβ1gene were examined in 11 HTLV‐1+patients with HL‐like disease.ResultsSix patients were classified as HTLV‐1+HL and five as HL‐like ATLL in accordance with genetic findings of HTLV‐1 proviral DNA integration and rearrangements of the TCRCβ1gene. Small ordinary looking lymphocytes with round nuclei were detected in the background of six patients with HTLV‐1+HL, which were immunohistochemically negative for CD25 and CC chemokine receptor (CCR)4 and had a low MIB1 labeling index (mean: 28.3%). In the HL‐like ATLL specimens, small‐ and medium‐sized atypical lymphocytes with indented and irregular‐shaped nuclei were found, and were diffusely positive for CD25 and CCR4, with high MIB1 labeling (mean: 76%). Both groups had scattered CD30+and CD15+Hodgkin and Reed Sternberg (RS) giant cells, with or without CD20 expression and Epstein‐Barr virus infection. The 50% overall survival period was significantly longer for the HTLV‐1+HL group (180 months) than for the HL‐like ATLL group (7.8 months;P= .004).ConclusionsHTLV‐1+HL showed typical small lymphoid cells with a low MIB1 labeling index in a background of Hodgkin and RS cells, with some scattered CD25+and CCR4+lymphocytes. In HTLV‐1 endemic areas, distinguishing HTLV‐1+HL from HL‐like ATLL is important because of their differing treatment strategies and prognoses.