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Liu J, Xia B, Jiang X, Cao L, Xi Z, Liang L, Zhang S, Zhang H, Li W. Single-cell landscape reveals the immune heterogeneity of bone marrow involvement in peripheral T-cell lymphoma. Cancer Sci 2024; 115:2540-2552. [PMID: 38845192 PMCID: PMC11309951 DOI: 10.1111/cas.16227] [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: 12/01/2023] [Revised: 03/03/2024] [Accepted: 05/02/2024] [Indexed: 08/10/2024] Open
Abstract
The prognosis of patients with peripheral T-cell lymphoma (PTCL) depends on bone marrow involvement (BMI). The bone marrow (BM) tumor microenvironment in PTCL remains unclear. We performed single-cell RNA sequencing (scRNA-seq) on 11 fresh BM samples from patients with BMI to reveal the associations of immune landscape and genetic variations with the prognosis of PTCL patients. Compared with PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL) had a higher number of T cells, lower number of lymphocytes, and greater inflammation. Immune heterogeneity in AITL is associated with prognosis. In particular, specific T-cell receptor (TCR) T cells are enriched in patients with good response to anti-CD30 therapy. We observed RhoA mutation-associated neoantigens. Chidamide-treated patients had a higher number of CD4+ regulatory cells and a better treatment response compared with other patients. In the nonresponder group, T-cell enrichment progressed to secondary B-cell enrichment and subsequently diffuse large B-cell lymphoma. Moreover, AITL patients with lymphoma-associated hemophagocytic syndrome had more T follicular helper (Tfh) cells with copy number variations in CHR5. To our knowledge, this study is the first to reveal the single-cell landscape of BM microenvironment heterogeneity in PTCL patients with BMI. scRNA-seq can be used to investigate the immune heterogeneity and genetic variations in AITL associated with prognosis.
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Affiliation(s)
- Jun Liu
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
- Department of Precision Medicine, Shenzhen HospitalSouthern Medical UniversityShenzhenChina
| | - Baijing Xia
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Xinmiao Jiang
- Department of Lymphoma, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Lixue Cao
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Zhihui Xi
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Liting Liang
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry of Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouChina
| | - Shaojun Zhang
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Hui Zhang
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry of Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouChina
| | - Wenyu Li
- Medical Research institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
- Department of Lymphoma, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
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2
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Hayashino K, Yoshida C, Ayata Y, Yukawa R, Komura A, Nakamura M, Meguri Y, Yamamoto K, Oda W, Imajo K. Extranodal natural killer/T-cell lymphoma coexisting with peripheral T-cell lymphoma, not otherwise specified. J Clin Exp Hematop 2024; 64:52-58. [PMID: 38538319 PMCID: PMC11079987 DOI: 10.3960/jslrt.23049] [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: 11/06/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 05/12/2024] Open
Abstract
We report the case of a 52-year-old male who presented to our hospital with cervical lymphadenopathy. Lymph node biopsy revealed small atypical lymphoid cells positive for CD3 and CD5 and negative for CD56 and Epstein-Barr virus (EBV)-encoded small RNA (EBER) by in situ hybridization. CD4-positive cells and CD8-positive cells were mixed in almost equal numbers. He was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). The patient received one cycle of chemotherapy, resulting in severe sepsis. While undergoing treatment in the intensive care unit with an antimicrobial agent and prednisone, ascitic fluid appeared. Abdominal aspiration revealed neutrophil-predominant ascites and microbiological studies revealed Candida albicans. However, ascites did not improve when treated with micafungin for Candida peritonitis. Abdominal aspiration was re-performed, and atypical lymphoid cells that were positive for CD3 and CD56 were detected. EBV-DNA levels in whole blood were significantly elevated. Atypical lymphoid cells were positive for EBER by in situ hybridization and Southern blot analysis showed EBV terminal repeat monoclonal patterns. Bone marrow examination revealed the same atypical lymphoid cells. Therefore, the patient was diagnosed with extranodal natural killer/T-cell lymphoma (ENKTL) with bone marrow involvement 3 months after the diagnosis of PTCL-NOS. Complications associated with PTCL-NOS and ENKTL are rare. PTCL-NOS, chemotherapy, sepsis, and prednisone might have led to immunodeficiency and reactivation of EBV, which might be one of the pathophysiologies for developing ENKTL. Our case indicates that measuring EBV-DNA in the blood is a simple and prompt examination to detect complications of EBV-associated lymphoma.
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MESH Headings
- Male
- Humans
- Middle Aged
- Epstein-Barr Virus Infections/complications
- Herpesvirus 4, Human
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/diagnosis
- Lymphoma, T-Cell, Peripheral/drug therapy
- Prednisone
- Lymphoma, Extranodal NK-T-Cell/complications
- Lymphoma, Extranodal NK-T-Cell/diagnosis
- Ascites/complications
- Ascites/pathology
- Killer Cells, Natural/pathology
- DNA
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3
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Aggressive Cutaneous Lymphomas and Their Mimics. Surg Pathol Clin 2023; 16:361-383. [PMID: 37149363 DOI: 10.1016/j.path.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Cutaneous lymphomas encompass a heterogeneous group of neoplasms with a wide spectrum of clinical presentations, histopathologic features, and prognosis. Because there are overlapping pathologic features among indolent and aggressive forms and with systemic lymphomas that involve the skin, clinicopathologic correlation is essential. Herein, the clinical and histopathologic features of aggressive cutaneous B- and T-cell lymphomas are reviewed. Indolent cutaneous lymphomas/lymphoproliferative disorders, systemic lymphomas, and reactive processes that may mimic these entities are also discussed. This article highlights distinctive clinical and histopathologic features, increases awareness of rare entities, and presents new and evolving developments in the field.
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4
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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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5
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Two cases of EBV infection preceding lymphoma. J Cancer Res Clin Oncol 2022; 148:2929-2932. [PMID: 35732965 PMCID: PMC9470712 DOI: 10.1007/s00432-022-04145-4] [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: 04/21/2022] [Accepted: 06/13/2022] [Indexed: 11/02/2022]
Abstract
Infection of lymphocytes with the Epstein-Barr virus (EBV) is a well-documented risk factor for developing lymphoma. The incidence of EBV positivity in lymphoma depends on the subtype and can range from 10% in diffuse large B-cell lymphoma (DLBCL) to 100% in endemic Burkitt lymphoma (BL), (Shannon-Lowe and Rickinson, Front Oncol 9:713, 2019). However, in most cases, EBV infection remains unnoticed until diagnosis of lymphoma is made. EBV seropositivity is present in > 90% of the world's population. Although mostly asymptomatic, in some cases, EBV can cause clinical symptoms, the most common of which are fever, lymphadenopathy and pharyngitis in infectious mononucleosis. Less common presentations include lymphomatoid granulomatosis and mucocutaneous ulcer. Here we report two cases of patients, who were initially diagnosed with localized EBV infection and reactive B-cell proliferation. After B-cell-directed treatment, both patients developed overt lymphoma, in one case classical Hodgkin's lymphoma (cHL) and in the other case angioimmunoblastic T-cell lymphoma (AITL).
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6
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Grossman M, Ruan J, Magro C. EPSTEIN-BARR VIRUS POSITIVE CD30 POSITIVE DIFFUSE LARGE B-CELL LYMPHOMA IN A PATIENT WITH ANGIOIMMUNOBLASTIC T-CELL LYMPHOMA. JAAD Case Rep 2022; 25:58-62. [PMID: 35755174 PMCID: PMC9218126 DOI: 10.1016/j.jdcr.2022.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Marc Grossman
- Department of Dermatology, Yale University, New Haven, Connecticut
- Hofstra/Northwell, Hyde Park, New York, New York
| | - Jia Ruan
- Department of Internal Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, New York, New York
| | - Cynthia Magro
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
- Correspondence to: Cynthia Magro, MD, Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, 1300 York Avenue F-309, New York, NY 10065.
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7
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Shin WY, Bang HI, Kim JA, Kim J, Park R. Angioimmunoblastic T-Cell Lymphoma with Polyclonal Proliferation of Plasma Cells: A Cautionary Note for Flow Cytometry Interpretations. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2022. [DOI: 10.15324/kjcls.2022.54.1.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Woo Yong Shin
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hae In Bang
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jung-Ah Kim
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jieun Kim
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Rojin Park
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
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8
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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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9
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Stoll JR, Willner J, Oh Y, Pulitzer M, Moskowitz A, Horwitz S, Myskowski P, Noor SJ. Primary cutaneous T-cell lymphomas other than Mycosis Fungoides and Sezary Syndrome - Part I: Clinical and histologic features and diagnosis. J Am Acad Dermatol 2021; 85:1073-1090. [PMID: 33940098 DOI: 10.1016/j.jaad.2021.04.080] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/12/2021] [Accepted: 04/26/2021] [Indexed: 11/11/2022]
Abstract
Primary cutaneous T-cell lymphomas (CTCLs) are defined as lymphomas with a T-cell phenotype that present in the skin without evidence of systemic or extracutaneous disease at initial presentation. CTCLs other than Mycosis Fungoides (MF) and Sézary syndrome (SS) account for approximately one-third of CTCLs and encompass a heterogenous group of non-Hodgkin lymphomas ranging from indolent lymphoproliferative disorders to aggressive malignancies with a poor prognosis. The spectrum of CTCLs continues to broaden as new provisional entities are classified. Given the morphologic and histologic overlap among CTCLs and other diagnoses, a thorough clinical history, physical evaluation, and clinicopathologic correlation are essential in the workup and diagnosis of these rare entities. This article will summarize the epidemiologic, clinical, pathologic, and diagnostic features of CTCLs other than MF and SS.
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Affiliation(s)
| | | | - Yuna Oh
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | - Sarah J Noor
- Memorial Sloan Kettering Cancer Center, New York, NY.
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10
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Ogura M, Kim WS, Uchida T, Uike N, Suehiro Y, Ishizawa K, Nagai H, Nagahama F, Sonehara Y, Tobinai K. Phase I studies of darinaparsin in patients with relapsed or refractory peripheral T-cell lymphoma: a pooled analysis of two phase I studies conducted in Japan and Korea. Jpn J Clin Oncol 2021; 51:218-227. [PMID: 33051668 PMCID: PMC7869082 DOI: 10.1093/jjco/hyaa177] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/31/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Two phase I studies of darinaparsin including Japanese and Korean patients with relapsed/refractory peripheral T-cell lymphoma were performed to evaluate its safety (primary purpose), efficacy and pharmacokinetic profile (ClinicalTrials.gov: NCT01435863 and NCT01689220). METHODS Patients received intravenous darinaparsin for 5 consecutive days at 200 mg/m2/day in 4-week cycles, 300 mg/m2/day in 4-week cycles or 300 mg/m2/day in 3-week cycles. RESULTS Seventeen Japanese and 6 Korean patients were enrolled and treated. Drug-related adverse events developed in 18 patients (78%). Dose-limiting toxicity, grade 3 hepatic dysfunction, was reported on Day 15 of cycle 1 in 1 Japanese patient who received 300 mg/m2/day. The most common drug-related, grade ≥ 3 adverse events were lymphopenia (9%), neutropenia (9%) and thrombocytopenia (9%). No deaths occurred. In 14 evaluable patients, 1 and 3 patients had complete response and partial response, respectively. The plasma concentration-time profiles of arsenic, a surrogate marker for darinaparsin, were similar between Japanese and Korean patients. No significant difference was found in its pharmacokinetic profile. CONCLUSIONS These data indicate the good tolerability and potential efficacy of darinaparsin in patients with relapsed/refractory peripheral T-cell lymphoma. Darinaparsin 300 mg/m2/day for 5 consecutive days in 3-week cycles is the recommended regimen for phase II study.
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Affiliation(s)
- Michinori Ogura
- Hematology and Oncology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
- Hematology and Oncology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Won-Seog Kim
- Hematology and Oncology, Samsung Medical Center, Seoul, Korea
| | - Toshiki Uchida
- Hematology and Oncology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Naokuni Uike
- Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
- Palliative Care, St. Mary's Hospital, Kurume, Japan
| | - Youko Suehiro
- Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kenichi Ishizawa
- Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
- Third Internal Medicine, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hirokazu Nagai
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Fumiko Nagahama
- Product Development Division, Solasia Pharma K.K., Tokyo, Japan
| | - Yusuke Sonehara
- Product Development Division, Solasia Pharma K.K., Tokyo, Japan
| | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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11
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Epstein-Barr Virus-Induced Cutaneous Diffuse Large B-Cell Lymphoma in a Patient With Angioimmunoblastic T-Cell Lymphoma. Am J Dermatopathol 2020; 41:927-930. [PMID: 31599749 DOI: 10.1097/dad.0000000000001371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous manifestations of Epstein-Barr virus (EBV)-driven B-cell lymphoid proliferations occur rarely as a result of severe immunodeficiency. To date, only a few cases of extranodal EBV-associated B-cell lymphomas arising in patients with angioimmunoblastic T-cell lymphoma (AITL) have been reported, and less common is a cutaneous presentation. AITL is a rare aggressive tumor that carries a poor prognosis and prompt diagnosis, and recognition of EBV-associated diffuse B-cell lymphoma is essential in these patients to instigate the correct treatment.
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12
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Ohmoto A, Fuji S. Cyclosporine for angioimmunoblastic T-cell lymphoma: a literature review. Expert Rev Hematol 2019; 12:975-981. [DOI: 10.1080/17474086.2019.1652590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Akihiro Ohmoto
- Division of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
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13
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Szablewski V, Dereure O, René C, Tempier A, Durand L, Alame M, Cacheux V, Costes-Martineau V. Cutaneous localization of angioimmunoblastic T-cell lymphoma may masquerade as B-cell lymphoma or classical Hodgkin lymphoma: A histologic diagnostic pitfall. J Cutan Pathol 2018; 46:102-110. [PMID: 30370547 DOI: 10.1111/cup.13382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/12/2018] [Accepted: 10/22/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND We report the cases of three patients presenting skin lesions whose biopsies showed nodular polymorphic infiltrates consisting of lymphocytes, plasma cells, histiocytes, eosinophils, B blasts, and Hodgkin Reed-Sternberg (HRS)-like cells. Two of them were initially diagnosed as classical Hodgkin lymphoma (cHL), on the other hand, the last one as a B-cell lymphoma. All patients have been treated for angioimmunoblastic T-cell lymphoma (AITL). METHODS We performed a second review of the skin biopsies with further immunophenotypic molecular analyses. Scrupulous observation revealed, in the background of the three cases, atypical small to medium-sized lymphocytes carrying a CD3+, CD4+ T-cell phenotype and expressing PD1 and CXCL13 follicular helper T-cell markers. The two lesions initially diagnosed as cHL showed scattered HRS-like cells with CD30+, CD15+, PAX5+, CD20-, Epstein Barr Virus (EBV) + classical phenotype. The case initially diagnosed as B-cell lymphoma showed a diffuse B-cell proliferation associated with small B-cell and medium to large-sized B blasts that were positive for EBV. CONCLUSION Those cases highlighted that atypical T-cells may be obscured by B-cell proliferation mimicking cHL or B-cell lymphoma in cutaneous localization of AITL and confirmed the requirement of collecting clinical information before performing a diagnosis.
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Affiliation(s)
- Vanessa Szablewski
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
| | - Olivier Dereure
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département de Dermatologie, CHU Montpellier, Hôpital Saint-Eloi, Montpellier
| | - Céline René
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Immunologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Ariane Tempier
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
| | - Luc Durand
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,MEDIPATH, Grabels, France
| | - Melissa Alame
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Hématologie Biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valère Cacheux
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Hématologie Biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valérie Costes-Martineau
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
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14
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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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15
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Jiang M, Lu H, Lu C, Geng X, Jia Y, Wang P, Qian W, Huang H, Shan X. Specific Soft-Tissue Invasion and LMP1 Expression Are Potential Indicators of Extranodal NK/T Cell Lymphoma, Nasal Type. Med Sci Monit 2018; 24:7603-7613. [PMID: 30356034 PMCID: PMC6213871 DOI: 10.12659/msm.909152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/21/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Extranodal NK/T cell lymphoma, nasal type (ENKTL-NT) is difficult to distinguish from nasal polyps and inverted papilloma, leading to its high misdiagnosis ratio. The aim of this study was to investigate its potential prognostic indicators. MATERIAL AND METHODS Kaplan-Meier method was used to calculate overall survival (OS) rate. Cox proportional hazards regression was used to analyze risk ratios (ORs) with 95% confidence intervals (CIs). RESULTS Nasal ala infiltration and nasal floor thickness >2.0 mm or nasal septum thickness >2.5 mm were potential prognostic factors for OS (p=0.0323 and 0.0072, respectively). Cox proportional-hazards regression indicated that high LMP1 expression and the nasal floor thickness >2.0 mm or nasal septum thickness >2.5 mm were the independent risk factors for poor OS of ENKTL-NT (HR=3.0655, p=0.028; HR=2.3650, p=0.0452, respectively). In the subgroup analysis, the OS rate was lower when the nasal floor thickness >2.0 mm or nasal septum thickness >2.5 mm in the patients who had high expression of LMP1 (p=0.0651), whereas high LMP1 expression increased the risk of worse prognostic outcome in patients with deep infiltration thickness. Thus, high LMP1 expression may contribute to the tissue invasion of ENKTL-NT. CONCLUSIONS Any patient with nasal ala soft-tissue invasion, nasal floor thickness >2.0 mm/nasal septum thickness >2.5 mm on CT imaging or high LMP1 expression should prompt immediate histopathologic diagnosis to rule out ENKTL-NT in clinical practice.
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Affiliation(s)
- Min Jiang
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Haoyue Lu
- School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Chao Lu
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Xingdong Geng
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Yingjun Jia
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Peng Wang
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Wei Qian
- Department of Otorhinolaryngology, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Hao Huang
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
| | - Xiuhong Shan
- Department of Medical Imaging, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China
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16
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Şimşek C, Bostankolu B, Özoğul E, Sağlam Ayhan A, Üner A, Büyükaşık Y. EBV-Related Diffuse Large B-Cell Lymphoma in a Patient with Angioimmunoblastic T-Cell Lymphoma. Turk J Haematol 2018; 36:57-59. [PMID: 30066674 PMCID: PMC6373506 DOI: 10.4274/tjh.galenos.2018.2018.0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Cem Şimşek
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Başak Bostankolu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Ece Özoğul
- Hacettepe University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Arzu Sağlam Ayhan
- Hacettepe University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Ayşegül Üner
- Hacettepe University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Yahya Büyükaşık
- Hacettepe University Faculty of Medicine, Division of Hematology, Ankara, Turkey
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17
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Lee MH, Moon IJ, Lee WJ, Won CH, Chang SE, Choi JH, Lee MW. A Case of Cutaneous Epstein-Barr Virus-Associated Diffuse Large B-Cell Lymphoma in an Angioimmunoblastic T-Cell Lymphoma. Ann Dermatol 2016; 28:789-791. [PMID: 27904290 PMCID: PMC5125972 DOI: 10.5021/ad.2016.28.6.789] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/10/2015] [Accepted: 11/13/2015] [Indexed: 12/04/2022] Open
Affiliation(s)
- Mi-Hye Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ik-Jun Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo-Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong-Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jee-Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi-Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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18
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Suárez AE, Artiga M, Santonja C, Montes-Moreno S, De Pablo P, Requena L, Piris MA, Rodríguez-Pinilla SM. Angioimmunoblastic T-cell lymphoma with a clonal plasma cell proliferation that underwent immunoglobulin isotype switch in the skin, coinciding with cutaneous disease progression. J Cutan Pathol 2016; 43:1203-1210. [DOI: 10.1111/cup.12814] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 08/19/2016] [Accepted: 08/30/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Ana E. Suárez
- Pathology Department; Hospital Universitario Fundación Jiménez Díaz; Madrid Spain
| | - M.J. Artiga
- Tumor Bank; Centro Nacional de Investigaciones Oncológicas; Madrid Spain
| | - Carlos. Santonja
- Pathology Department; Hospital Universitario Fundación Jiménez Díaz; Madrid Spain
| | | | - P. De Pablo
- Dermatology Department; Hospital del Tajo; Madrid Spain
| | - Luis Requena
- Dermatology Department; Hospital Universitario Fundación Jiménez Díaz; Madrid Spain
| | - Miguel A. Piris
- Pathology Department; Hospital Universitario Marqués de Valdecilla; Santander Spain
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19
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Extranodal Marginal Zone Lymphoma-like Presentations of Angioimmunoblastic T-Cell Lymphoma: A T-Cell Lymphoma Masquerading as a B-Cell Lymphoproliferative Disorder. Am J Dermatopathol 2016; 37:604-13. [PMID: 25839892 DOI: 10.1097/dad.0000000000000266] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is the second most common type of peripheral T-cell lymphoma worldwide, and in some countries, it is the most common form. Clinically, AITL usually presents with systemic symptoms, diffuse lymphadenopathy, hepatosplenomegaly, and common laboratory abnormalities such as hypergammaglobulinemia. Rashes are seen in 50%-80% of patients. AITL derives from follicular T-helper cells (TFH), that express germinal center markers and produce hyperactivation of B-cells seen in AITL. Although the histological features of AITL in the skin could be similar to pathological findings present in lymph node biopsies, herein, we present 2 cases of AITL with histological and immunophenotypic features that were somewhat suggestive of extranodal marginal zone lymphoma. Caution is urged to exclude the possibility of a systemic T-cell lymphoma such as AITL in cutaneous and lymph node B-cell proliferations.
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20
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Hoffmann JC, Chisholm KM, Cherry A, Chen J, Arber DA, Natkunam Y, Warnke RA, Ohgami RS. An analysis of MYC and EBV in diffuse large B-cell lymphomas associated with angioimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma not otherwise specified. Hum Pathol 2015; 48:9-17. [PMID: 26772393 DOI: 10.1016/j.humpath.2015.09.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 09/25/2015] [Accepted: 09/30/2015] [Indexed: 01/12/2023]
Abstract
Composite diffuse large B-cell lymphomas (DLBCLs) with peripheral T-cell lymphomas (PTCLs) are rare co-occurrences with poorly understood pathologic features. Herein, we describe 15 distinct cases of DLBCL occurring in association with PTCL, including angioimmunoblastic T-cell lymphoma (AITL; n = 12) and PTCL, not otherwise specified (n = 3). Sheets of large B cells were seen in all cases, with Hodgkin/Reed-Sternberg-like (HRS-L) cells present in 6 cases. When compared to cases of AITL without DLBCL, HRS-L cells were more frequently seen in cases of AITL with DLBCL (P = .02). Epstein-Barr virus (EBV) expression was seen in 10 of 15 cases, and in those with HRS-L cells, EBV expression was detected invariably in at least a subset of the HRS-L cells. MYC gene rearrangements were consistently absent, although 6 of the 10 cases showed MYC overexpression by immunohistochemistry in the neoplastic B cells; a frequency significantly increased compared to other cases of DLBCL not associated with a T-cell lymphoma: 29 of 166 (P = .005). In addition, when MYC was overexpressed in DLBCL, it was also weakly present in the HRS-L cells. The increased and frequent morphologic presence of HRS-L cells in association with this composite lymphoma raises a possible link between their occurrence and DLBCLs in PTCLs; furthermore, the frequent detection of MYC protein expression and EBV infection in these cases suggests a possible role of these pathways in B-cell lymphomagenesis.
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21
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Santonja C, Soto C, Manso R, Requena L, Piris MA, Rodríguez-Pinilla SM. Primary cutaneous follicular helper T-cell lymphoma. J Cutan Pathol 2015; 43:164-70. [DOI: 10.1111/cup.12614] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 08/13/2015] [Accepted: 08/16/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - Carlos Soto
- Hematology Department; Fundación Jiménez Díaz; Madrid Spain
| | - Rebeca Manso
- Pathology Department; Fundación Jiménez Díaz; Madrid Spain
| | - Luis Requena
- Dermatology Department; Fundación Jiménez Díaz; Madrid Spain
| | - Miguel Angel Piris
- Pathology Department; Hospital Universitario Marqués de Valdecilla; Santander Spain
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22
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Maughan C, Boudreaux L, Lear W, Bohlke A. Discordant mycosis fungoides and cutaneous B-cell lymphoma: A case report and review of the literature. JAAD Case Rep 2015; 1:219-21. [PMID: 27051734 PMCID: PMC4808734 DOI: 10.1016/j.jdcr.2015.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cory Maughan
- Silver Falls Dermatology/Western University of Health Sciences, Salem, Oregon
| | | | - William Lear
- Silver Falls Dermatology/Western University of Health Sciences, Salem, Oregon
| | - Angela Bohlke
- Silver Falls Dermatology/Western University of Health Sciences, Salem, Oregon
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23
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Zhou Y, Rosenblum MK, Dogan A, Jungbluth AA, Chiu A. Cerebellar EBV-associated diffuse large B cell lymphoma following angioimmunoblastic T cell lymphoma. J Hematop 2015; 8:235-241. [PMID: 27559423 DOI: 10.1007/s12308-015-0241-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Epstein-Barr virus (EBV)-associated B cell lymphoproliferative disorders may be seen in patients with angioimmunoblastic T cell lymphoma (AITL). Although both nodal and extranodal sites of involvement have been described, central nervous system involvement by B cell lymphoma following AITL has not previously been documented. We report a first example of such unusual presentation, in which an 80-year-old man developed diffuse large B cell lymphoma (DLBCL) in the cerebellum 4 months after the initial diagnosis of AITL. EBV-encoded RNAs were detected in the DLBCL, suggesting that EBV played a pivotal role in the pathogenesis of high-grade histologic progression of AITL. The patient survived less than 9 months after his initial diagnosis of AITL. We believe that this case expands the spectrum of extranodal manifestation of EBV-positive B cell lymphoma associated with AITL and illustrates the importance of recognition of this association when encountering unusual central nervous system lesions in patients with known AITL.
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Affiliation(s)
- Yi Zhou
- Department of Pathology, Loyola University Medical Center, Rm 2222, Building 110, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Marc K Rosenblum
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Ahmet Dogan
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Achim A Jungbluth
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - April Chiu
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
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24
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Ocampo-Garza J, Herz-Ruelas ME, González-Lopez EE, Mendoza-Oviedo EE, Garza-Chapa JI, Ocampo-Garza SS, Vázquez-Herrera NE, Miranda-Maldonado I, Ocampo-Candiani J. Angioimmunoblastic T-cell lymphoma: a diagnostic challenge. Case Rep Dermatol 2014; 6:291-5. [PMID: 25685133 PMCID: PMC4307011 DOI: 10.1159/000370302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) accounts for 15–20% of all peripheral T-cell lymphomas. It is a rare subtype of CD4 T-cell peripheral lymphoma that affects aged individuals, causing B symptoms, generalized lymphadenopathy and hepatosplenomegaly. Its pathogenesis is still unclear, but in some cases it has been associated with infection, allergic reaction or drug exposure. The majority of patients are diagnosed in an advanced stage and anthracycline based regimen is considered the first-line therapy. Skin involvement is not well characterized, occurring in up to 50% of patients and presenting as nonspecific rash, macules, papules, petechiae, purpura, nodules and urticaria. We present the illustrative case of a 55-year-old woman with an AITL who presented prominent skin findings, arthritis, lymphadenopathy and hypereosinophilia. Skin biopsy reported a T-cell lymphoma and the diagnosis of AITL was confirmed by an axillary lymph node biopsy, which was also positive for Epstein-Barr virus. Chemotherapy with CHOP-21 and thalidomide was given, accomplishing complete remission after six cycles.
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Affiliation(s)
- Jorge Ocampo-Garza
- Department of Dermatology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Maira Elizabeth Herz-Ruelas
- Department of Dermatology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Elias Eugenio González-Lopez
- Department of Hematology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Eric Eduardo Mendoza-Oviedo
- Department of Pathology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Juana Irma Garza-Chapa
- Department of Dermatology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Sonia Sofía Ocampo-Garza
- Department of Dermatology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Norma Elizabeth Vázquez-Herrera
- Department of Dermatology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ivett Miranda-Maldonado
- Department of Pathology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Jorge Ocampo-Candiani
- Department of Dermatology, University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico
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25
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Independent growth of diffuse large B cell lymphoma and angioimmunoblastic T cell lymphoma originating from composite lymphoma. Ann Hematol 2014; 93:1801-3. [PMID: 24488225 DOI: 10.1007/s00277-014-2018-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
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26
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Gru AA, Lu D. Concurrent malignant melanoma and cutaneous involvement by classical Hodgkin lymphoma (CHL) in a 63 year-old man. Diagn Pathol 2013; 8:135. [PMID: 23938065 PMCID: PMC3765467 DOI: 10.1186/1746-1596-8-135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/21/2013] [Indexed: 12/26/2022] Open
Abstract
Abstract Classical Hodgkin lymphoma (CHL) is a lymphoproliferative disorder that has a bimodal age distribution, affecting young and elderly individuals, and is curable in more than 90% of patients. Here we report the coexistence of cutaneous CHL and malignant melanoma as the presentation of papules and a plaque, in an individual with remote history of systemic CHL. One of the biopsies showed a mononuclear cell infiltrate with Reed-Sternberg (RS) like cells that were positive for CD30 and CD15, but negative for CD45. A second concurrent biopsy showed an atypical melanocytic proliferation with significant pagetoid spreading and diffuse Melan-A staining. Based on morphology alone, it is almost impossible to distinguish CHL from other primary cutaneous lymphoproliferative disorders, such as CD30+ lymphoproliferative disorder (lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large-cell lymphoma), or even tumor stage mycosis fungoides when the epidermotropism is minimal. Additionally, bizarre melanocytic cells can also appear similar to RS cells. Our case illustrates the first case report of malignant melanoma and CHL in a patient presenting simultaneously. Virtual slides The virtual slide(s) for this article can be found here:
http://www.diagnosticpathology.diagnomx.eu/vs/8979757349937225
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27
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Lee E, Kim TM, Lim Y, Jeon YK, Go H, Kim CW, Heo DS. Histologic transformation of Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly. J Clin Oncol 2013; 31:e332-4. [PMID: 23715578 DOI: 10.1200/jco.2012.44.7375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Eunyoung Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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28
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Strunk JE, Schüttler C, Ziebuhr J, Stowasser M, Nöhte M, Mayer K, Bräuninger A, Gattenlöhner S. Epstein-Barr virus-induced secondary high-grade transformation of Sjögren's syndrome-related mucosa-associated lymphoid tissue lymphoma. J Clin Oncol 2013; 31:e265-8. [PMID: 23630202 DOI: 10.1200/jco.2012.46.8439] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Mao Y, Zhang DW, Zhu H, Lin H, Xiong L, Cao Q, Liu Y, Li QD, Xu JR, Xu LF, Chen RJ. LMP1 and LMP2A are potential prognostic markers of extranodal NK/T-cell lymphoma, nasal type (ENKTL). Diagn Pathol 2012; 7:178. [PMID: 23237707 PMCID: PMC3539909 DOI: 10.1186/1746-1596-7-178] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 12/06/2012] [Indexed: 12/22/2022] Open
Abstract
Background Latent membrane protein (LMP) 1 and LMP2A encoded by Epstein-Barr virus (EBV) are associated with the development of malignancies, but their expression in extranodal NK/T-cell lymphoma, nasal type (ENKTL) and the relationship with clinical characteristics of this disease remain poorly understood. In the present study, we examined the expression of LMP1 and LMP2A in ENKTL, and investigated the correlations between LMP1 and LMP2A expression with clinicopathological characteristics of ENKTL patients. Methods Paraffin sections of surgically removed samples from 16 ENKTL patients were analyzed by immunohistochemistry and the related clinicopathological data were collected and analyzed. Results Elevated expression (immunohistochemistry score ≥ 4) of LMP1 and LMP2A was detected in the tumor cells of ENKTL. High LMP1 expression was associated with positive B symptoms (p = 0.012), while high LMP2A expression was related to gender (p = 0.029). The expression of both LMP1 and LMP2A showed significant correlations with patients’ overall survival (p = 0.049, p = 0.036). Conclusion LMP1 and LMP2A may be prognostic indicators of survival in patients with ENKTL. Virtual slides http://www.diagnosticpathology.diagnomx.eu/vs/2443352538545899
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Affiliation(s)
- Yuan Mao
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Nanjing Medical University, No,121 Jiang jia yuan, Nanjing 210011, China
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30
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Ambrosio MR, Rocca BJ, Ginori A, Onorati M, Fabbri A, Carmellini M, Lazzi S, Tripodi S. Renal infarction due to polyarteritis nodosa in a patient with angioimmunoblastic T-cell lymphoma: a case report and a brief review of the literature. Diagn Pathol 2012; 7:50. [PMID: 22568881 PMCID: PMC3487756 DOI: 10.1186/1746-1596-7-50] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 04/22/2012] [Indexed: 11/10/2022] Open
Abstract
Angioimmunoblastic T-cell lymphoma is one of the most common subtypes of peripheral T-cell lymphoma (15-20% of all cases), accounting for approximately 1-2% of all non-Hodgkin lymphomas. It often presents autoimmune phenomena including hemolytic anemia, thrombocytopenia, glomerulonephrities and circulating immune complexes. Polyarteritis nodosa is an autoimmune disease characterized by necrotizing vasculitis of medium vessels, which rarely develops in association with hematological malignant disorders. Herein we report the case of a 40-year-old man who underwent lymph node biopsy in the suspicious of sarcoidosis. On the basis of histological and immunohistochemical findings, the diagnosis of angioimmunoblastic T-cell lymphoma was performed. The patient was successfully treated with cytarabine-based regimen for 6 cycles. Three months after the initial diagnosis of angioimmunoblastic T-cell lymphoma, a whole body computed tomography showed a lesion in the lower pole of the left kidney. Renal cell carcinoma was suspected, thus a nephrectomy was carried out. The histological findings were compatible with polyarteritis nodosa. To the best of our knowledge, the association between polyarteritis nodosa and angioimmunoblastic T-cell lymphoma has been described only once. This relation may be secondary to the induction of an autoimmune phenomenon by the lymphoma with the formation of circulating immune complexes, leading to vessels walls injury. A careful evaluation is needed in the management of angioimmunoblastic T-cell lymphoma patients with signs of renal failure in order to avoid delay of treatment and organ damage.
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Affiliation(s)
- Maria Raffaella Ambrosio
- Department of Human Pathology and Oncology, Pathological Anatomy Section, University of Siena, via delle Scotte, Siena, 6-53100, Italy.
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