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Baker J, Zadeh SL, Aguilera NS. ALK-positive large B-cell lymphoma (ALK + LBCL) with aberrant CD3 expression. J Hematop 2024; 17:109-114. [PMID: 38573563 PMCID: PMC11127819 DOI: 10.1007/s12308-024-00582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/27/2024] [Indexed: 04/05/2024] Open
Abstract
ALK-positive ( +) large B cell lymphoma (ALK + LBCL) is a rare distinct subtype of diffuse large B cell lymphoma presenting with high stage and aggressive behavior. Although B cell markers such as CD20, CD19, and CD22 are generally negative, plasmacytic markers including CD138, CD38, and MUM1 are positive. T cell markers are negative with rare exceptions. We report an unusual case of ALK1 + LBCL in a 58-year-old man with partial expression of CD3 without other T cell antigen expression. The tissue was evaluated with flow cytometry, immunohistochemistry, fluorescent in situ hybridization, and gene rearrangement studies. Gene rearrangement studies for IGH and TCR gamma were performed. Flow cytometry did not demonstrate any abnormal lymphoid populations. Tissue sectioning shows a malignant plasmacytic large cell neoplasm which expresses CD45 but is negative for CD20, CD79a, and PAX5. Plasmacytic markers CD138 and MUM1 are positive with kappa light chain restriction. Strong granular cytoplasmic expression of ALK is present. FISH showing disrupted ALK supports the diagnosis while MYC, BCL6, and BCL2 are intact. Gene rearrangement studies show coexisting IGH and TCR gamma clones; however, the TCR peak was present within a polyclonal background suggesting the disputed cells are likely only a subset of the T cell population. ALK + LBCL can present with an ambiguous immunophenotype, which warrants the use of multiple B cell, T cell, and plasmacytic antibodies. CD3 expression in this entity is rare and of uncertain clinical significance, but warrants further study.
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MESH Headings
- Humans
- Male
- Middle Aged
- CD3 Complex/metabolism
- CD3 Complex/genetics
- Anaplastic Lymphoma Kinase/genetics
- Anaplastic Lymphoma Kinase/metabolism
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Receptor Protein-Tyrosine Kinases/genetics
- Receptor Protein-Tyrosine Kinases/metabolism
- In Situ Hybridization, Fluorescence
- Gene Rearrangement
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Immunohistochemistry
- Immunophenotyping
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Affiliation(s)
- Jess Baker
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, 22901-0214, USA
- Associated Pathologists PA, Tampa, FL, USA
| | - Sara L Zadeh
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, 22901-0214, USA
| | - Nadine S Aguilera
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, 22901-0214, USA.
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2
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Ponzo G, Umana GE, Valastro M, Giuffrida M, Tranchina MG, Nicoletti GF, Scalia G. Cervical radiculopathy as first presentation of CD3-positive diffuse large B-cell lymphoma of the cervico-thoracic junction. Br J Neurosurg 2023; 37:1190-1193. [PMID: 33012208 DOI: 10.1080/02688697.2020.1828278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 09/21/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) in rare cases can presents an unusual expression of CD3 T-cell specific antigen. We report the first case of a CD3-positive DLBCL of the cervico-thoracic junction presenting with persistent cervical radiculopathy. CASE PRESENTATION A 74-years-old male patient presented a severe and persistent right C8 radiculopathy associated with right-sided neck pain, progressive numbness and weakness of the right arm. The symptoms prominent during the night interfering with sleep and were resistant to anti-inflammatory drugs and cervical orthosis. Spine MRI showed a solid hypointense lesion on T2-weighted images and hyperintense on STIR sequences involving the epidural space at C7, T1 and T2. The patient underwent a C7-T1 decompressive laminectomy and left T2 hemilaminectomy with resection of the epidural tissue resulting in subtotal removal. Histology showed a DLBCL germinal center B-cell lymphoma with expression of CD3 T-cell specific antigen. Then the patient underwent adjuvant radiotherapy and chemotherapy consisting of R-CHOP protocol. At last follow-up (2 years) the patient is still in good clinical status (KPS = 80) with almost complete recovery of the cervical radiculopathy. CONCLUSIONS To our knowledge this is the first case of DLBLC GCB-like CD3 positive to present with radiculopathy.
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Affiliation(s)
- Giancarlo Ponzo
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy
| | - Giuseppe Emmanuele Umana
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy
| | - Maurizio Valastro
- Radiodiagnostic Unit, Highly Specialized Hospital of National Importance "Garibaldi", Catania, Italy
| | - Massimiliano Giuffrida
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy
| | | | | | - Gianluca Scalia
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy
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3
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Blastoid Variant Mantle Cell Lymphoma Expressing Aberrant CD3 and CD10 with Concurrent Small Lymphocytic Lymphoma: Establishment of a Clonal Relationship by B- and T-Cell Receptor Gene Rearrangements. Case Rep Hematol 2019; 2018:8303571. [PMID: 30627460 PMCID: PMC6305046 DOI: 10.1155/2018/8303571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/11/2018] [Indexed: 11/18/2022] Open
Abstract
Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin B-cell lymphoma typically expressing CD19, CD20, CD5, FMC-7, CyclinD1, and SOX-11 and harboring the IgH/CCND1 translocation. We report a blastoid variant of mantle cell lymphoma (MCL) involving an inguinal lymph node that, in addition to classical phenotypic and genetic findings, also aberrantly coexpresses surface CD10 and cytoplasmic CD3. Small lymphocytic lymphoma (SLL) was also present in the same lymph node and in the bone marrow. B- and T-cell gene rearrangement studies by PCR show the MCL and SLL to be clonally related. Expression of multiple aberrant antigens and concurrent lymphomas of different classifications can cause a diagnostic challenge. Awareness of such a presentation and integration of the data from morphologic evaluation, flow cytometry, immunohistochemistry, and FISH studies is required for proper diagnosis, prognosis, and therapy.
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Yang LH, Ingersoll K, Zhao Y, Luedke C, Sebastian S, Wang E. CD3-positive diffuse large B-cell lymphoma relapses as CD3-negative large B-cell lymphoma: Loss of aberrant antigen expression in B-cell lymphoma after chemotherapy. Pathol Res Pract 2018; 214:1738-1744. [PMID: 30025593 DOI: 10.1016/j.prp.2018.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/15/2018] [Accepted: 07/05/2018] [Indexed: 01/26/2023]
Abstract
Aberrant expression of CD3 on diffuse large B-cell lymphoma (DLBCL) is rare, and its mechanism and biological significance are currently unclear. Herein we report a case of Epstein-Barr virus-negative, CD3-positive DLBCL in a 53 year-old male, who had a remote history of renal transplantation. After standard chemotherapy, the patient was in clinical remission. He relapsed three years later, but at this time with apparent loss of CD3 expression. PCR-based IGK gene rearrangement studies demonstrated clonal amplicons with an identical nucleotide size between the primary and secondary DLBCL, confirming the clonal relationship despite their phenotypic differences. To our knowledge, this is the first case of CD3-positive DLBCL that demonstrated a loss of aberrant CD3 on relapse. The chronologic change in phenotype seen in this case suggests that the source of the patient's lymphoma relapse may arise from either a quiescent subclone without CD3 expression, or from an upstream neoplastic precursor cell.
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Affiliation(s)
- Lian-He Yang
- Department of Pathology, First Affiliated Hospital, College of Basic Sciences of China Medical University, Shenyang, 110013, PR China; Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, United States
| | - Kimberly Ingersoll
- Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, United States
| | - Yue Zhao
- Department of Pathology, First Affiliated Hospital, College of Basic Sciences of China Medical University, Shenyang, 110013, PR China; Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, United States
| | - Catherine Luedke
- Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, United States
| | - Siby Sebastian
- Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, United States
| | - Endi Wang
- Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, United States.
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5
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Pan Z, Chen M, Zhang Q, Wang E, Yin L, Xu Y, Huang Q, Yuan Y, Zhang X, Zheng G, Yuan J. CD3-positive plasmablastic B-cell neoplasms: a diagnostic pitfall. Mod Pathol 2018; 31:718-731. [PMID: 29327711 DOI: 10.1038/modpathol.2017.177] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 12/19/2022]
Abstract
Rare B-cell neoplasms with plasmablastic differentiation may aberrantly express CD3 by immunohistochemical staining, which places a great challenge for diagnosis. We here studied 17 cases of CD3+ plasmablastic B-cell neoplasms, including 12 plasmablastic lymphomas and 5 plasmablastic plasma cell myelomas. All 17 cases occurred in the extranodal sites with a male predominance (13/17). Four cases were initially misinterpreted by outside institutions, among which three were diagnosed as 'peripheral T-cell lymphoma, not otherwise specified' and one was classified as 'poorly differentiated neuroendocrine carcinoma'. The plasmablastic cells were present in all 17 cases diffusely or in a subset of tumor cells. CD3 expression was mostly diffuse (12/17) and moderate to strong (11/16) with a cytoplasmic staining pattern (14/16). Other T-cell markers were nearly absent, including CD2 (0/10), CD4 (1/13), CD5 (0/14), CD7 (0/11), and CD8 (0/13). CD138 was positive in all 17 cases and CD79a was variably positive in 8 of 14 cases. Only one case had immunoreactivity to CD20 (1/17) and PAX5 (1/12). CD56 expression and EBV infection were detected in 8/15 and 6/17, respectively. No HHV8 infection was noted in all 11 cases tested. Most cases (11/13) revealed either kappa or lambda light chain restriction. Of the nine cases studied, six had clonal IGH rearrangements but no clonal TRG rearrangements. Our study further emphasizes that the accurate classification of CD3+ plasmablastic neoplasms requires thorough morphologic examination, incorporation of more B-cell and T-cell markers in addition to CD3 and CD20, frequent addition of CD138 staining, and utilization of necessary molecular and genetic studies.
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Affiliation(s)
- Zenggang Pan
- Department of Pathology, University of Colorado Denver, Aurora, CO, USA
| | - Mingyi Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Qianyun Zhang
- Department of Pathology, University of New Mexico, Albuquerque, NM, USA
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Liqun Yin
- Incyte Diagnostics, Spokane Valley, WA, USA
| | - Youyuan Xu
- Department of Pathology, Woodhull Medical and Mental Health Center, Brooklyn, NY, USA
| | - Qin Huang
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Youzhong Yuan
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Xiaohui Zhang
- Department of Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gang Zheng
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Ji Yuan
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
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6
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Tsuyama N, Ennishi D, Yokoyama M, Baba S, Asaka R, Mishima Y, Terui Y, Hatake K, Takeuchi K. Clinical and prognostic significance of aberrant T-cell marker expression in 225 cases of de novo diffuse large B-cell lymphoma and 276 cases of other B-cell lymphomas. Oncotarget 2018; 8:33487-33500. [PMID: 28380441 PMCID: PMC5464884 DOI: 10.18632/oncotarget.16532] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/28/2017] [Indexed: 12/24/2022] Open
Abstract
Expression of T-cell markers, generally investigated for immunophenotyping of T-cell lymphomas, is also observed in several types of B-cell lymphomas, including diffuse large B-cell lymphoma (DLBCL). We previously reported that CD5 expression in DLBCL is an inferior prognostic factor in the era of rituximab. However, data regarding the frequencies, histological relevance, and prognostic importance of T-cell markers other than CD5 are currently unavailable. In the present study, we comprehensively evaluated the expression of T-cell markers (CD2, CD3, CD4, CD5, CD7, and CD8) in 501 B-cell lymphomas, including 225 DLBCLs, by flow cytometry and subsequent immunohistochemistry. T-cell markers other than CD5, such as CD2, CD4, CD7, and CD8, were expressed in 27 (5%) patients, and notably, all of these cases were classified as large B-cell lymphoma subtypes: 25 DLBCLs and 2 intravascular large B-cell lymphomas. CD5 and other T-cell markers were expressed in 15% (31/225) and 10% (25/225) of DLBCL cases, respectively. Five of them co-expressed CD5 and other T-cell markers. Retrospectively analyzing the prognostic relevance of T-cell markers in 169 patients with primary DLBCL treated with rituximab-based chemotherapy, we showed that only CD5 was a strong predictor of poor survival. This study provides information about the occurrence of T-cell markers other than CD5 in B-cell lymphomas, their frequent histological subtypes, and their prognostic significance in DLBCL. CD5 was reconfirmed as a negative prognostic marker in DLBCL patients receiving rituximab-inclusive chemotherapy, whereas T-cell markers other than CD5 were found to have no impact on clinicopathological and survival analyses.
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Affiliation(s)
- Naoko Tsuyama
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Daisuke Ennishi
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masahiro Yokoyama
- Department of Hematology Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Baba
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Reimi Asaka
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuko Mishima
- Department of Hematology Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuhito Terui
- Department of Hematology Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kiyohiko Hatake
- Department of Hematology Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
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7
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Ferry JA. There Are No Magic Bullets in Hematopathology: Even Immunostains for CD20 and CD3 Can Get You Into Trouble. Adv Anat Pathol 2018; 25:14-23. [PMID: 28914619 DOI: 10.1097/pap.0000000000000174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Immunohistochemistry is a powerful tool for the diagnosis and subclassification of hematolymphoid neoplasms. However, the expression of certain markers is not always as expected, and unusual patterns of staining can lead to misdiagnosis. CD20 and CD3 are our most commonly used markers for identification of B cells and T cells, respectively, and they almost always yield reliable, specific staining. This discussion focuses on diagnostic pitfalls related to the use of immunohistochemistry for CD20 and CD3 in hematopathology, and specifically on diagnostic challenges that arise when (1) CD20 is not expressed in B-cell lymphomas, when (2) CD20 is expressed in plasma cell neoplasms and T-cell lymphomas, and when (3) CD3 is expressed in B-cell lymphomas and Hodgkin lymphoma.
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8
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Shimada M, Fukuda M, Horio K, Suyama T, Kitazaki T, Hashiguchi K, Fukuda M, Shigematsu K, Nakamura Y, Honda T, Ashizawa K, Mukae H. Primary Mediastinal Large B-cell Lymphoma Exhibiting Endobronchial Involvement. Intern Med 2016; 55:3147-3150. [PMID: 27803409 PMCID: PMC5140864 DOI: 10.2169/internalmedicine.55.7117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Primary mediastinal large B-cell lymphoma (PMLBCL) is one of the subtypes of diffuse large B-cell lymphoma. We experienced a rare case of PMLBCL that exhibited endobronchial involvement. A 33-year-old Japanese female with the chief complaints of epigastralgia, back pain, and nausea visited a primary care hospital. Computed tomography of the chest and abdomen demonstrated a bulky mass in the left anterior mediastinum, multiple pulmonary nodules, axillary lymph node swelling, and a pancreatic tumor. Fiberoptic bronchoscopy showed a white-tinged irregularly shaped endobronchial tumor accompanied by capillary vessel dilation in the left upper lobar bronchus. Taken together, these findings resulted in a diagnosis of PMLBCL.
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Affiliation(s)
- Midori Shimada
- Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital, Japan
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9
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Taniguchi A, Hashida Y, Nemoto Y, Machida H, Chi S, Ikezoe T, Yokoyama A, Daibata M. Epstein-Barr Virus-Positive Pyothorax-Associated Lymphoma Arising from a Posttraumatic Empyema. Acta Haematol 2015; 134:155-60. [PMID: 25968626 DOI: 10.1159/000380809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 02/10/2015] [Indexed: 11/19/2022]
Abstract
Pyothorax-associated lymphoma (PAL) develops from a pyothorax caused by an artificial pneumothorax created during the treatment of pulmonary tuberculosis or tuberculous pleuritis. We report the first case of Epstein-Barr virus (EBV)-positive PAL arising from a posttraumatic empyema. A 75-year-old woman with chronic posttraumatic empyema presented with a tumor, which was connected to the wall of a pyothorax in the right thoracic cavity. She had a history of trauma to the right chest, which had occurred at the age of 45 years and had caused the chronic posttraumatic empyema. Pathological features of the resected tumor were conclusive for a diagnosis of EBV-positive PAL. Although neither postoperative chemotherapy nor radiotherapy was performed, remission was maintained for 3 years until recurrence in the liver. Combination chemotherapy led to complete remission, and 9 years after the initial diagnosis of PAL, the patient is still alive. An intriguing finding is the phenotypic alteration during the disease course. Although the primary tumor was negative for CD20 and CD3, the recurrent tumor expressed both of these molecules. We discuss this case of PAL, which was not a complication of lung tuberculosis, and the aberrant chronological phenotypic change observed in the lymphoma cells, and compare it with a usual case of PAL.
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Affiliation(s)
- Ayuko Taniguchi
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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10
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Thalheim L, Williams L, Borst L, Fogle J, Suter S. Lymphoma Immunophenotype of Dogs Determined by Immunohistochemistry, Flow Cytometry, and Polymerase Chain Reaction for Antigen Receptor Rearrangements. J Vet Intern Med 2013; 27:1509-16. [DOI: 10.1111/jvim.12185] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/12/2013] [Accepted: 08/06/2013] [Indexed: 12/22/2022] Open
Affiliation(s)
- L. Thalheim
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC
| | - L.E. Williams
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC
- Center for Comparative Medicine and Translational Research; North Carolina State University; Raleigh NC
| | - L.B. Borst
- Center for Comparative Medicine and Translational Research; North Carolina State University; Raleigh NC
- Department of Population Health and Pathobiology; College of Veterinary Medicine; North Carolina State University; Raleigh NC
| | - J.E. Fogle
- Center for Comparative Medicine and Translational Research; North Carolina State University; Raleigh NC
- Department of Population Health and Pathobiology; College of Veterinary Medicine; North Carolina State University; Raleigh NC
| | - S.E. Suter
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC
- Center for Comparative Medicine and Translational Research; North Carolina State University; Raleigh NC
- Lineberger Comprehensive Cancer Center; Chapel Hill NC
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11
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Lin Z, Chen B, Xu X, Wang X, Lin G. Analysis of clinical characteristics of 516 patients with non-Hodgkin's lymphoma in Shanghai area. ACTA ACUST UNITED AC 2013; 19:99-106. [PMID: 23795960 DOI: 10.1179/1607845413y.0000000097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The aim was to determine the clinical and cytogenetic characteristics of non-Hodgkin's lymphoma (NHL) in Shanghai. A retrospective analysis was conducted in 516 patients with NHL. Patient clinical data, including age, sex, diagnosis, immunophenotypes, and karyotypes, were collected. The median age was 58 years. There was a male predominance in all NHL, except extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Patients with B cell NHL (1.5%) expressed CD3. T cell NHL patients (11.5%) expressed CD20. Epstein-Barr virus latent integral membrane protein 1, BCL6, CD10, Bcl-2, CD68, myeloperoxidase, CD99, CD30, CD15, and CD43 were present in various types of NHL. Complex karyotypes accounted for 92.3% of the 73.7% patients with abnormal karyotypes. Immunoglobin heavy chain gene translocation was present in 60.3% of B cell and 23.7% of T/NK cell neoplasms. Understanding the complex clinicopathological and molecular features of NHL may help with prognosis and serve as targets for treatments.
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12
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A Rare Case of Primary Thymic Hodgkin Lymphoma in an Elderly Patient Detected by 18F-FDG PET/CT. Clin Nucl Med 2013; 38:e236-8. [DOI: 10.1097/rlu.0b013e318252e01b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Xu Z, Padmore R, Faught C, Duffet L, Burns BF. Langerhans cell sarcoma with an aberrant cytoplasmic CD3 expression. Diagn Pathol 2012; 7:128. [PMID: 23006414 PMCID: PMC3502395 DOI: 10.1186/1746-1596-7-128] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 09/23/2012] [Indexed: 12/13/2022] Open
Abstract
Abstract Langerhans cell sarcoma is a rare and aggressive high grade hematopoietic neoplasm with a dismal prognosis. It has a unique morphological and immunotypic profile with a CD1a/ langerin/S100 + phenotype. T cell lineage markers except for CD4 in Langerhans cell sarcoma have not been documented previously. We report a case of 86 year-old male of Caucasian descent who presented with an enlarging right neck mass over 2 months with an underlying unknown cause of anemia. Computed tomography scan of the neck, chest and abdomen revealed generalized lymphadenopathy and mild splenomegaly suspicious for lymphoma. Diagnostic core biopsy performed on right neck mass revealed a possible T cell lymphoma with expression of T cell lineage specific marker CD3 but conclusive diagnosis could not be made due to insufficient core biopsy sample. Further excisional biopsy performed on a left inguinal node showed a hematopoietic neoplasm with features of Langerhans cell sarcoma with a focal cytoplasmic CD3 expression in 30-40% of the tumor cells. PCR for T cell receptor (TCR) gene rearrangement failed to demonstrate a clonal gene rearrangement in the tumor cells arguing against a T cell lineage transdifferentiation, suggesting an aberrant CD3 expression. To the best of our knowledge, this case represents the first report of Langerhans cell sarcoma with an aberrant cytoplasmic CD3 expression. Virtual slides http://www.diagnosticpathology.diagnomx.eu/vs/2065486371761991
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Affiliation(s)
- Zhaodong Xu
- Department of Pathology and Laboratory Medicine, Division of Hematopathology, The Ottawa Hospital, Ottawa, Ontario, Canada.
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14
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Clinicopathologic Features of B-Cell Lineage Neoplasms With Aberrant Expression of CD3. Am J Surg Pathol 2012; 36:1364-70. [DOI: 10.1097/pas.0b013e31825e63a9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Plasmablastic lymphoma involving the penis: a previously unreported location of a case with aberrant CD3 expression. Pathology 2011; 43:54-7. [PMID: 21240066 DOI: 10.1097/pat.0b013e328340bbba] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lymphomas of the penis are rare and can either arise at this site or be a manifestation of systemic disease. We report the case of an elderly man with a plasmablastic lymphoma (PBL) involving the uncircumcised penile prepuce. The neoplasm was composed of plasmablasts positive for monotypic immunoglobulin lambda light chain, CD3, CD79a, CD138 and Epstein-Barr virus encoded RNA (EBER), and was negative for CD2, CD5, CD7, CD20, and PAX5. This case is highly unusual for at least two reasons. The penile foreskin is a rare location for lymphoma and PBL at this site has not been reported. Secondly, the tumour was shown by immunohistochemistry to be positive for the T-cell marker CD3. Lineage ambiguity in terminally differentiated B-cell lymphomas has been reported to be closely related with immune compromise and is associated with Epstein-Barr virus infection. The literature on penile lymphomas is also reviewed.
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16
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CD4-positive diffuse large B cell lymphoma identified by flow cytometry: two case reports. Int J Hematol 2010; 92:198-203. [PMID: 20577835 DOI: 10.1007/s12185-010-0631-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 05/19/2010] [Accepted: 06/06/2010] [Indexed: 12/13/2022]
Abstract
We report two cases of diffuse large B cell lymphoma (DLBCL), both occurring in the small bowel, which coexpress PAX5, weak or no CD20 and the CD4 antigen. The CD4 was initially identified by flow cytometry and then confirmed by immunohistochemistry. CD4 is a representative marker for helper T-lymphocytes and is present on a subset of thymocytes, peripheral T cells and monocytes or macrophages. Unlike CD2 and CD5, no B cell fractions are known to express CD4. It might be hypothesized that the deregulated control of gene expression in malignant B cells, in particular PAX5, leads to the activation of some silent or repressed genes of T cell differentiation. Although lineage infidelity is described in some B lymphomas, it remains as an uncommon phenomenon; to our knowledge, cases reported here are the first two cases of DLBCL of the gastrointestinal tract coexpressing the CD4 antigen to be described to date.
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