期刊
AMERICAN JOURNAL OF SURGICAL PATHOLOGY
卷 36, 期 11, 页码 1636-1646出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PAS.0b013e318268d9ff
关键词
follicular peripheral T-cell lymphoma; angioimmunoblastic T-cell lymphoma; Reed-Sternberg cell; classical Hodgkin lymphoma; follicular helper T cells
资金
- INCa (Institut National du Cancer)
- ARC (Association pour la Recherche contre le Cancer)
- FRM (Fondation pour la Recherche Medicale, equipe labellisee)
- Association pour la Recherche Therapeutique, Genetique et Immunologique dans les Lymphomes (ARTGIL)
Epstein-Barr virus (EBV)-infected B cells with Reed-Sternberg-like cell (RS) features may occur in peripheral T-cell lymphomas (PTCLs), especially in angioimmunoblastic T-cell lymphoma. Here, we report 5 patients presenting with lymphadenopathy whose first biopsies demonstrated nodular lymphoid proliferations containing scattered CD30(+), CD15(+), EBV+ Hodgkin and Reed-Sternberg-like cells, which led to an initial diagnosis of lymphocyte-rich classical Hodgkin lymphoma. However, the uncommon clinical features and/or the occurrence of relapse as PTCL prompted review of the biopsies with expanded immunohistologic and molecular studies and revision of the diagnoses to follicular variant of PTCL (F-PTCL). All cases had atypical small to medium-sized CD3(+) T cells that expressed CD10 (4/5) and the follicular helper T-cell (TFH) antigens BCL6, PD1, CXCL13, and ICOS. All demonstrated clonal T cells with a similar pattern in multiple samples from 4 patients. In 2 cases, flow cytometry demonstrated circulating lymphocytes with an abnormal sCD3(-), CD4(+), ICOS+ immunophenotype. Two patients had a skin rash at presentation, and 1 had B symptoms. Two of the 4 patients treated with polychemotherapy are alive at 3 and 6 years after first diagnosis. These cases highlight how some F-PTCLs may closely mimic lymphocyte-rich classical Hodgkin lymphoma requiring careful assessment of the T cells before rendering the latter diagnosis. The functional properties of TFH cells might lead to the presence of EBV-positive B blasts with RS-like features in TFH-derived PTCL such as angioimmunoblastic T-cell lymphoma and F-PTCL.
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