title: T-cell lymphoblastic lymphoma with eosinophilia associated with subsequent myeloid malignancy.
abstract: Three patients with T-cell lymphoblastic lymphoma and peripheral blood eosinophilia are reported. At the time of diagnosis, all patients had lymphadenopathy, and one had a mediastinal mass. Lymph node biopsies revealed lymphoblastic lymphoma admixed with a variable number of mature eosinophils. Immunophenotypic studies demonstrated that each lymphoma had an immature T-cell immunophenotype. Bone marrow biopsies were hypercellular with myeloid hyperplasia and eosinophilia but were negative for lymphoma. All patients received multiagent chemotherapy; one patient achieved a complete remission, and two patients had partial remissions. All patients subsequently developed a myeloid malignancy. Two died of acute myeloid leukemia within 18 months of the diagnosis of lymphoblastic lymphoma. The third patient relapsed with a lymphoma that had histologic and immunophenotypic features of both T-cell lymphoblastic lymphoma and granulocytic sarcoma and also developed a poorly defined myeloproliferative disorder. These findings suggest that T-cell lymphoblastic lymphoma associated with eosinophilia may represent a distinct clinico-pathologic entity with a high risk of subsequent myeloid neoplasia.
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
authors.forename: L V
authors.initials: LV
authors.lastname: Abruzzo
authors.forename: E S
authors.initials: ES
authors.lastname: Jaffe
authors.forename: J D
authors.initials: JD
authors.lastname: Cotelingam
authors.forename: J
authors.initials: J
authors.lastname: Whang-Peng
authors.forename: V
authors.initials: V
authors.lastname: Del Duca
authors.forename: L J
authors.initials: LJ
authors.lastname: Medeiros
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D003582:Cytogenetics; D004802:Eosinophilia / Q000150:complications*; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D016130:Immunophenotyping; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D009196:Myeloproliferative Disorders / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology