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Hoshi D, Migita N, Ishizawa S, Sato Y, Yamamura K, Kiyokawa E. Co-occurrence of Epstein-Barr virus-positive nodal T/NK-cell lymphoma and nodal T-follicular helper cell lymphoma of different clonal origins: An autopsy case report. Pathol Int 2024; 74:346-351. [PMID: 38578156 DOI: 10.1111/pin.13425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
Nodal T-follicular helper cell lymphoma (TFHL) is a subset of T-cell lymphoma and frequently co-occurs with Epstein-Barr virus (EBV)-positive B-cell lymphoma but not with T/NK-cell lymphoma. Recently, a new entity with a worse prognosis, called EBV-positive nodal T/NK-cell lymphoma (NTNKL) has been established. Here, we report an autopsy case of synchronous multiple lymphomas, including TFHL and NTNKL. The patient was a 78-year-old female admitted with pneumonia. Although pneumonic symptoms were improved, fever, pancytopenia, and disseminated intravascular coagulation emerged, implicating lymphoma. She died on the 21st hospital day without a definitive diagnosis. The autopsy revealed the enlargement of multiple lymph nodes throughout her body. Histological analysis revealed three distinct regions in the left inguinal lymph node. The first region consists of small-sized lymphocytes with T-follicular helper phenotype and extended follicular dendritic cell meshwork, indicating TFHL. The second region included EBV-positive large B cells. The third region comprised EBV-positive large cells with cytotoxic T/NK cell phenotype, indicating NTNKL. Clonality analysis of the first and the third regions showed different patterns. Since various hematopoietic malignancies progress from common clonal hematopoiesis according to existing literature, this case may help to understand TFHL and NTNKL.
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Affiliation(s)
- Daisuke Hoshi
- Department of Oncologic Pathology, Kanazawa Medical University, Ishikawa, Japan
- Department of Diagnostic Pathology, Kanazawa University Hospital, Ishikawa, Japan
| | - Nami Migita
- School of Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Shin Ishizawa
- Department of Pathology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Yasuharu Sato
- Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Koichi Yamamura
- Department of Respiratory Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Etsuko Kiyokawa
- Department of Oncologic Pathology, Kanazawa Medical University, Ishikawa, Japan
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2
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Zhang F, Li W, Cui Q, Chen Y, Liu Y. Case Report: Immune Microenvironment and Mutation Features in a Patient With Epstein–Barr Virus Positive Large B-Cell Lymphoma Secondary to Angioimmunoblastic T-Cell Lymphoma. Front Genet 2022; 13:940513. [PMID: 35938041 PMCID: PMC9354849 DOI: 10.3389/fgene.2022.940513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/20/2022] [Indexed: 01/24/2023] Open
Abstract
On rare occasions, secondary Epstein–Barr virus (EBV)-associated B-cell lymphoma can develop in patients with angioimmunoblastic T-cell lymphoma (AITL). Here, we describe the tumor microenvironment and mutation features of a patient with EBV + large B-cell lymphoma (LBCL) secondary to AITL. He was admitted to hospital due to a 1-year history of fever and enlarged right inguinal lymph nodes. A biopsy of the right inguinal lymph node demonstrated that numerous diffuse medium-sized atypical lymphocytes proliferated, together with increased extrafollicular follicular dendritic cell meshwork, and the lymphocytes expressed CD3, CD4, BCL6, CD10, PD-1, CXCL13, and Ki-67 (75%). Thus, a diagnosis of AITL was made. However, the disease progressed following treatment by CHOP regimen (cyclophosphamide, adriamycin, vincristine, and prednisone). Biopsy showed that most of the cells were positive for CD20 staining and IgH rearrangement. Analysis of 22 kinds of immune cells showed that the numbers of activated NK cells and activated memory T cells increased, while the T-follicular helper population decreased in the transformed sample. In addition, compared with the primary sample, RHOA (G17V) mutation was not detected, while JAK2 and TRIP12 gene mutations were detected in the transformed sample. Overall, we described the immune microenvironment and mutation features of a patient with EBV + LBCL secondary to AITL. This study will help us to understand the mechanisms by which AITL transforms to B-cell lymphoma.
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3
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Hashimoto A, Asai S, Tanaka Y, Shinzato I. Epstein-Barr Virus-Positive Adrenal Diffuse Large B-Cell Lymphoma after Treatment for Angioimmunoblastic T-Cell Lymphoma. Eur J Case Rep Intern Med 2021; 8:002533. [PMID: 34790617 DOI: 10.12890/2021_002533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/11/2021] [Indexed: 11/05/2022] Open
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) can be complicated by Epstein-Barr virus (EBV)-positive B-cell lymphoma. B-cell lymphoma may develop simultaneously at the time of AITL diagnosis or after treatment for AITL. EBV-associated B-cell lymphoma can occur in nodal and extranodal sites. We report a case of EBV-positive diffuse large B-cell lymphoma (DLBCL) of the left adrenal gland that developed after treatment for AITL. The patient presented with systemic lymphadenopathy and biopsy of one lymph node showed AITL. A complete response (CR) was achieved after initial chemotherapy for AITL, but 9 months later the left adrenal gland was enlarged. The diagnosis of EBV-positive DLBCL was made based on the histopathological findings of the left adrenal gland biopsy. Thus, EBV-positive DLBCL developed after AITL CR was achieved. Multi-drug chemotherapy combined with rituximab was administered for adrenal DLBCL, but only a partial response was achieved. We confirmed that EBV-positive B-cell lymphoma developed after treatment for AITL. An adrenal primary is rare, and this is only the second case of EBV-positive B-cell lymphoma to be reported after treatment for AITL. Clinicians should keep in mind that when nodal and extranodal lesions are seen after AITL treatment, another biopsy should be performed for the accurate determination of whether these lesions indicate AITL relapse or new-onset EBV-positive B-cell lymphoma. LEARNING POINTS We report a case of EBV-positive B-cell lymphoma of the adrenal gland after treatment for angioimmunoblastic T-cell lymphoma (AITL)When patients present with signs and symptoms suggestive of relapse after AITL treatment, another biopsy should be performed for the accurate determination of whether these lesions indicate AITL relapse or new-onset of EBV-positive B-cell lymphoma.The involvement of extranodal sites may indicate a poor prognosis of EBV-positive B-cell lymphoma after AITL treatment.
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Affiliation(s)
- Akiko Hashimoto
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan
| | - Satsuki Asai
- Department of Pathology, Kobe City Nishi-Kobe Medical Center, Japan
| | - Yasuhiro Tanaka
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan
| | - Isaku Shinzato
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan
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Sirinoglu D, Yavuz AY, Sarigul B, Aydin MV. Cerebellar non-germinal center type diffuse B-cell lymphoma: Case report. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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5
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Wang C, Gong Y, Jiang Q, Liang X, Chen R. Epstein-Barr virus positive diffuse large B-cell lymphoma transformed into angioimmunoblastic T-cell lymphoma after treatment. Clin Case Rep 2021; 9:e04083. [PMID: 34084501 PMCID: PMC8142414 DOI: 10.1002/ccr3.4083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/06/2021] [Accepted: 03/13/2021] [Indexed: 11/11/2022] Open
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is the subtype of mature T-cell non-Hodgkin lymphoma. Compared with diffuse large B-cell lymphoma (DLBCL), AITL patients are frequently accompanied with Epstein-Barr virus (EBV) infection. To date, there is no report on the subsequent development of AITL in patients with EBV-positive DLBCL. We performed a rare case of EBV-positive AITL developing one year after initial diagnosis of EBV-positive DLBCL. The patient showed poor response to the chemotherapy regimen, and poor survival.
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Affiliation(s)
- Chaoyu Wang
- Department of Hematology‐OncologyChongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized TreatmentChongqing University Cancer HospitalChongqingChina
| | - Yi Gong
- Department of Hematology‐OncologyChongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized TreatmentChongqing University Cancer HospitalChongqingChina
| | - Qingming Jiang
- Department of PathologyChongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized TreatmentChongqing University Cancer HospitalChongqingChina
| | - Xiping Liang
- Department of Hematology‐OncologyChongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized TreatmentChongqing University Cancer HospitalChongqingChina
| | - Rui Chen
- Department of PathologyChongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized TreatmentChongqing University Cancer HospitalChongqingChina
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Hu P, Ben Y, Liu J, Zheng W, Yan X, Zhang Y, Shi W. Promising Response to Lenalidomide-Combination Therapy in a Discordant Lymphoma Consisting of EBV-Positive Diffuse Large B-Cell Lymphoma and Angioimmunoblastic T-Cell Lymphoma: A Case Report. Onco Targets Ther 2021; 14:2489-2495. [PMID: 33883903 PMCID: PMC8053605 DOI: 10.2147/ott.s297539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022] Open
Abstract
Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) complicated with angioimmunoblastic T-cell lymphoma (AITL) is extremely rare and typically shows an aggressive clinical course and unsatisfactory prognosis. Here, we describe the case of a 77-year-old man who was referred to the hospital because of repeated fever, night sweats, and weight loss. He was finally diagnosed with a discordant lymphoma consisting of AITL and DLBCL, with significantly different maximum standardized uptake values on positron emission tomography/computed tomography. Based on his complex illness and poor performance status, the patient received six cycles of lenalidomide combined with R-miniCHOP regimen and achieved complete remission with tolerable and controlled toxicity. He subsequently received lenalidomide maintenance therapy and achieved sustained remission. We consider the possible causes of this discordance involved AITL and EBV-positive DLBCL, and the possible mechanism of lenalidomide action in both T-cell and B-cell non-Hodgkin lymphomas. Lenalidomide-combination therapy may be a preferable choice in patients with an EBV-associated discordant lymphoma.
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Affiliation(s)
- Pan Hu
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
| | - Yu Ben
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
| | - Juan Liu
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
| | - Weicheng Zheng
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
| | - Xiyue Yan
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
| | - Yaping Zhang
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
| | - Wenyu Shi
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China.,Department of Hematology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China
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7
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Kim CH, Ghaffaripour T, Zhou Y, Chapman JR. Overlap between EBV-positive diffuse large B-cell lymphoma, NOS, in a young patient and angioimmunoblastic T-cell lymphoma: A diagnostic pitfall. Clin Case Rep 2021; 9:1371-1375. [PMID: 33768847 PMCID: PMC7981666 DOI: 10.1002/ccr3.3778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
There may be significant histopathologic overlap between EBV-positive DLBCL, NOS, and other diagnoses including angioimmunoblastic T-cell lymphoma (AITL). Resolution of this differential diagnosis may be particularly challenging and require extensive investigation of clinicopathologic features.
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Affiliation(s)
- Chae Hwa Kim
- Division of HematopathologyDepartment of Pathology and Laboratory MedicineUniversity of Miami and Sylvester Comprehensive Cancer CenterMiamiFLUSA
| | - Taban Ghaffaripour
- Division of HematopathologyDepartment of Pathology and Laboratory MedicineUniversity of Miami and Sylvester Comprehensive Cancer CenterMiamiFLUSA
| | - Yi Zhou
- Division of HematopathologyDepartment of Pathology and Laboratory MedicineUniversity of Miami and Sylvester Comprehensive Cancer CenterMiamiFLUSA
| | - Jennifer R. Chapman
- Division of HematopathologyDepartment of Pathology and Laboratory MedicineUniversity of Miami and Sylvester Comprehensive Cancer CenterMiamiFLUSA
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8
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Statuto T, D'Auria F, Del Vecchio L, Mansueto GR, Villani O, Lalinga AV, Possidente L, Nozza F, Vona G, Rago L, Storto G, Gasparini VR, Zambello R, D'Arena G, Valvano L. Atypical Mature T-Cell Neoplasms: The Relevance of the Role of Flow Cytometry. Onco Targets Ther 2020; 13:7605-7614. [PMID: 32848413 PMCID: PMC7425660 DOI: 10.2147/ott.s258512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022] Open
Abstract
Lymphoproliferative disorders are a heterogeneous group of malignant clonal proliferations of lymphocytes whose diagnosis remains challenging, despite diagnostic criteria are now well established, due to their heterogeneity in clinical presentation and immunophenotypic profile. Lymphoid T-cell disorders are more rarely seen than B-cell entities and more difficult to diagnose for the absence of a specific immunophenotypic signature. Flow cytometry is a useful tool in diagnosing T-cell lymphoproliferative disorders since it is not only able to better characterize T-cell neoplasms but also to resolve some very complicated cases, in particular those in which a small size population of neoplastic cells is available for the analysis. Here, we report three patients with mature T-cell neoplasms with atypical clinical and biological features in which analysis of peripheral blood and bone marrow specimens by means of multicolor flow cytometry was very useful to identify and characterize three rare T-cell lymphoproliferative disorders, such as angioimmunoblastic T-cell lymphoma, peripheral T-cell lymphoma not otherwise specified and T-cell prolymphocytic leukemia. The aim of this case series report is not only to describe three rare cases of lymphoproliferative neoplasms but also to raise awareness that a fast, highly sensitive, and reproducible procedure, such as flow cytometry immunophenotyping, can have a determinant diagnostic role in these patients.
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Affiliation(s)
- Teodora Statuto
- Laboratory of Clinical Research and Advanced Diagnostics, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Fiorella D'Auria
- Unit of Clinical Pathology, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Luigi Del Vecchio
- CEINGE Biotecnologie Avanzate S.c.a.r.l, Federico II University, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnology (DMMBM), Federico II University, Naples, Italy
| | - Giovanna Rosaria Mansueto
- Hematology Department of Basilicata, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Oreste Villani
- Hematology Department of Basilicata, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Anna Vittoria Lalinga
- Pathology Unit, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Luciana Possidente
- Pathology Unit, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Filomena Nozza
- Laboratory of Clinical Research and Advanced Diagnostics, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Gabriella Vona
- Laboratory of Clinical Research and Advanced Diagnostics, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Luciana Rago
- Radiotherapy Unit, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Giovanni Storto
- Department of Nuclear Medicine, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Vanessa Rebecca Gasparini
- Department of Medicine, University of Padova - Veneto Institute of Molecular Medicine, VIMM, Padova, PD, Italy
| | - Renato Zambello
- Hematology and Clinical Immunology, Department of Medicine, Padua School of Medicine, Padova, PD, Italy
| | - Giovanni D'Arena
- Hematology Department of Basilicata, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
| | - Luciana Valvano
- Laboratory of Clinical Research and Advanced Diagnostics, Centro Di Riferimento Oncologico Della Basilicata (IRCCS-CROB), Rionero in Vulture, Pz, Italy
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Lee T, Park BG, You E, Cho YU, Jang S, Lee SM, Suh C, Park CJ. Bone Marrow Involvement of Epstein-Barr Virus-Positive Large B-Cell Lymphoma in a Patient with Angioimmunoblastic T-Cell Lymphoma. Ann Lab Med 2019; 38:172-175. [PMID: 29214764 PMCID: PMC5736679 DOI: 10.3343/alm.2018.38.2.172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/22/2017] [Accepted: 11/14/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Taegeun Lee
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Borae G Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
| | - Eunkyoung You
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Young Uk Cho
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Sun Mi Lee
- Department of Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Cheolwon Suh
- Department of Oncology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chan Jeoung Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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Hong R, Sheng L, Ouyang G. Composite angioimmunoblastic T cell/diffuse large B-cell lymphoma treated with reduced-intensity conditioning HLA-haploidentical allo-HSCT: a case report and review of the literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2018; 11:5473-5480. [PMID: 31949632 PMCID: PMC6963011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/25/2018] [Indexed: 06/10/2023]
Abstract
Cases of diffuse large B-cell lymphoma (DLBCL) occurring together with angioimmunoblastic T cell lymphoma (AITL) are rare. Treatments for AITL and DLBCL composite lymphoma include chemotherapy, targeted therapy, immunomodulatory therapy and hematopoietic stem cell transplantation, but no standard treatment for this aggressive disease has yet been defined. There are no case reports on AITL/DLBCL composite lymphoma treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Herein, we report a case of AITL/DLBCL composite lymphoma treated with reduced-intensity conditioning HLA-haploidentical allo-HSCT, and the patient still remains in complete remission (CR) after a year of regular follow-up.
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Affiliation(s)
- Ruimin Hong
- Department of Hematology, The Affiliated Ningbo Hospital of Zhejiang University Ningbo 315000, Zhejiang, China
| | - Lixia Sheng
- Department of Hematology, The Affiliated Ningbo Hospital of Zhejiang University Ningbo 315000, Zhejiang, China
| | - Guifang Ouyang
- Department of Hematology, The Affiliated Ningbo Hospital of Zhejiang University Ningbo 315000, Zhejiang, China
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11
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Zhu W, He QY, Lu C, Fu CY, Zhou JH, Liu S, Tao YG, Xiao DS. Detection of immunoglobulin and T-cell receptor gene rearrangements in angioimmunoblastic T-cell lymphoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2018; 11:2642-2653. [PMID: 31938379 PMCID: PMC6958285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/12/2018] [Indexed: 06/10/2023]
Abstract
Objective: To assess the value of immunoglobulin and T-cell receptor gene rearrangements in the diagnosis and differential diagnosis of angioimmunoblastic T-cell lymphoma. Methods: We selected 55 cases of angioimmunoblastic T-cell lymphoma confirmed by histopathology and 15 cases of reactive lymph node hyperplasia. Using the IdentiClone gene rearrangement detection kit, BIOMED-2 primer system, and GeneScanning analysis, we tested for immunoglobulin and T-cell receptor gene rearrangements. Results: Among all 55 angioimmunoblastic T-cell lymphoma cases, 1 (2%) displayed the first type of angioimmunoblastic T-cell lymphoma, which has an intact lymphoid follicle structure. Five cases (9%) displayed the second type, which has an intact segmental lymphatic follicular structure. Forty-nine cases (89%) displayed the third type, which is characterized by a complete obliteration of the lymphatic follicular structure. Fifty-two cases (95%) had tumor cells that were positive for CD3, 50 cases (91%) were positive for CD4, 33 cases (60%) were positive for Bcl-6, 20 cases (36%) were positive for CD10, 44 cases (80%) were positive for CXCL13 to different degrees, and 53 cases (96%) showed a strong positive expression of CD21. Ki67 expression intensity was 30-80% in tumor T cells. Clonal gene rearrangements were identified in 48 of the 55 angioimmunoblastic T-cell lymphoma cases (87%), of which 30 (55%) displayed IG gene rearrangements, including IGHA (7 cases; 13%), IGHB (6 cases; 11%), IGHC (2 cases; 4%), IGKA (22 cases; 40%), IGKB (6 cases; 11%), and IGL (20 cases; 36%). TCR gene rearrangements were observed in 32 cases (58%), including TCRBA (6 cases; 11%), TCRBB (5 cases; 9%), TCRBC (10 cases; 18%), TCRD (7 cases; 13%), TCRGA (22 cases; 40%), and TCRGB (16 cases; 29%). IG and TCR gene rearrangements were concurrently observed in 14 cases (25%). Immunoglobulin or TCR clonal gene rearrangements were not detected in the 15 cases of reactive hyperplasia. Conclusions: Angioimmunoblastic T-cell lymphomas may be positive for immunoglobulin or T-cell receptor clone gene rearrangements or may express double rearrangements. The assessment of clonal gene rearrangements is valuable for the diagnosis and differential diagnosis of angioimmunoblastic T-cell lymphoma.
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Affiliation(s)
- Wei Zhu
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Cancer Research Institute, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
| | - Qiu-Yan He
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Cancer Research Institute, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
| | - Can Lu
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Cancer Research Institute, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
| | - Chun-Yan Fu
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Cancer Research Institute, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
| | - Jian-Hua Zhou
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Cancer Research Institute, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
| | - Shuang Liu
- Department of Pathology, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
| | - Yong-Guang Tao
- Center for Medicine Research, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Department of Pathology, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
- Key Laboratory of Carcinogenesis and Cancer Invasion (Central South University), Ministry of EducationHunan, China
- Key Laboratory of Carcinogenesis (Central South University), Ministry of HealthHunan, China
| | - De-Sheng Xiao
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, Hunan, China
- Cancer Research Institute, School of Basic Medicine, Central South UniversityChangsha, Hunan, China
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12
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Watanabe M, Mizuta S, Koba Y, Ukyo N, Tamekane A. Epstein-Barr virus positive diffuse large B cell lymphoma with G17V RHOA mutation arising from peripheral T cell lymphoma, not otherwise specified. Ann Hematol 2017; 97:361-362. [PMID: 29063178 DOI: 10.1007/s00277-017-3152-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
MESH Headings
- Aged
- Amino Acid Substitution
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Epstein-Barr Virus Infections/genetics
- Humans
- Karyotyping
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/genetics
- Male
- Mutation, Missense
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/virology
- Point Mutation
- Remission Induction
- Salvage Therapy
- rhoA GTP-Binding Protein/genetics
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Affiliation(s)
- Mitsumasa Watanabe
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki, Hyogo, Japan.
| | - Shumpei Mizuta
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Yusuke Koba
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Naoya Ukyo
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Akira Tamekane
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki, Hyogo, Japan
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