Sinonasal NK/T-cell lymphomas in the United States
Sinonasal NK/T-cell lymphomas in the United States
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DOI：
10.1097/00000478-200011000-00006
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发表时间：
2000-11-01
影响因子：
5.6
通讯作者：
Arber, DA
中科院分区：
文献类型：
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作者：
Gaal, K;Sun, NCJ;Arber, DA
鼻窦自然杀伤细胞（NK）/T细胞淋巴瘤在亚洲和南美洲和中美洲地区很常见，但在美国很少见，在那里它们还没有得到很好的表征。对15例发生在南加州的乳腺癌进行了组织学、免疫表型、EB病毒EBER原位杂交（EBER-ISH）和T细胞受体γ链（TCR-γ）基因重排研究。尽管仅7例患者的种族背景可用，但6例为亚洲或西班牙裔，仅1例已知为非西班牙裔白色。12例表现为鼻窦病变，但3例仅限于口咽部。大多数病例（11/15）表现为坏死和血管破坏性模式。所有病例均显示胞浆CD 3阳性（15/15），TIA-I和颗粒酶B均阳性（14/14）。14例中5例穿孔素阳性。15例中有10例表达CD 56，3例表达CD 8。EBER-ISH阳性13例，TCR-γ基因重排1例。无（0/14）为CD 16或CD 57阳性。虽然CD 16阳性组织细胞是丰富的，双标记EBER-ISH/IHC未能确定EBV阳性肿瘤细胞上的CD 16表达。3例多形性大细胞形态显示局灶性CD 30阳性，提高了间变性大细胞淋巴瘤的鉴别诊断，但均为ALK-1阴性，其他方面与其他NK/T细胞淋巴瘤相似。在美国，鼻窦NW T细胞淋巴瘤最常发生在报告频率高的地区（亚洲、中美洲和南美洲）的少数民族人群中，尽管比地方性人群中少见，但在其他方面表现相似。一个综合的方法，包括免疫组化，EBER-ISH和TCR基因重排研究，是最有助于达到正确的诊断。
Sinonasal natural killer (NK)/T-cell lymphomas are common in Asia and areas of South and Central America but are rarely seen in the United States, where they have not been as well characterized. Fifteen cases diagnosed in Southern California were studied with respect to histologic features, immunophenotype, Epstein-Barr virus EBER in-situ hybridization (EBV EBER-ISH), and T-cell receptor gamma chain (TCR-gamma) gene rearrangement. Although ethnic background was available for only seven patients, six were of Asian or Hispanic descent with only one non-Hispanic white known. Twelve presented as sinonasal lesions, but three were limited to the oropharynx. Most cases (11 of 15) demonstrated both necrosis and an angiodestructive pattern. All cases demonstrated cytoplasmic CD3 positivity (15 of 15), and were positive for both TIA-I and granzyme B (14 of 14). Perforin was positive in 5 of 14. CD56 was expressed in 10 of 15 and CD8 in 3 of 15. EBV EBER-ISH was positive in 13 of 14 and TCR-gamma gene rearrangement was detected in 1 of 14 cases. None (0 of 14) were positive for CD16 or CD57. Although CD16-positive histiocytes were abundant, double-label EBER-ISH/IHC failed to identify CD16 expression on EBV-positive tumor cells. Three cases with pleomorphic large cell morphology showed focal CD30 positivity, raising the differential diagnosis of anaplastic large cell lymphoma, but all were ALK-1-negative and otherwise similar to the other cases of NK/T-cell lymphoma. Sinonasal NWT-cell lymphomas in the United Stares most often occur in ethnic soups from areas of reported high frequency (Asia, Central and South America), although less commonly than in endemic populations, and are otherwise similar phenotypically. A combined approach, including immunohistochemistry, EBV EBER-ISH, and TCR gene rearrangement studies, is most helpful to arrive at the correct diagnosis.