title: CD20+ T-cell lymphoma. Neoplastic transformation of a normal T-cell subset.
abstract: CD20 is a 35-kDa protein that is expressed early in B-cell ontogeny and is lost during terminal B-cell differentiation into plasma cells. It is thought to be B-cell-specific. However, the CD20 antigen, detected by the monoclonal antibody L26, has been reported in some cases of T-cell lymphoma. This report describes a case of a malignant lymphoma coexpressing T-cell-lineage antigens and CD20 and characterization of a CD20+ T-cell population in the peripheral blood of healthy donors. The tumor cells were pleomorphic medium-sized cells that expressed a range of T-cell-specific antigens, including CD2, CD3, CD4, CD5, CD6, CD7, and beta F1. In addition, the tumor cells expressed CD20 on frozen (B1) and paraffin sections (L-26). Stains for other pan-B cell antigens, including CD19 and CD22, and immunoglobulin light and heavy chains were negative. To determine whether this unusual coexpression of T-cell-lineage antigens and CD20 represented aberrant antigen expression or neoplastic transformation of an unusual normal T-cell subset, the authors examined specimens of peripheral blood lymphocytes from healthy donors for evidence of a CD20+ T-cell population by using three-color immunofluorescence analysis by flow cytometry. Two distinct populations of CD20+ cells were observed in peripheral blood. One expressed bright CD20 (6.6% to 23.7%, mean 14.47% of peripheral blood lymphocytes) and other B-cell associated antigens, whereas the other expressed dim CD20 (.94% to 11.90%, mean 3.50% of peripheral blood lymphocytes) and coexpressed CD3. Approximately two thirds (52.8% to 82.3%, mean 64.1%) of the dim CD20 cells were CD8+ and one third (19.2% to 74.1%, mean 37.5) CD4+. These cells also expressed CD5 and the alpha-beta chain of the T-cell receptor and lacked CD19 and CD22. These results indicate that CD20 is expressed on some normal peripheral blood T cells. CD20 expression by T-cell lymphomas may represent neoplastic transformation of a normal subset of CD20+ T cells rather than aberrant antigen expression by neoplastic cells. The nature of the CD20 antigen on T cells and the function of the normal population remain to be determined.
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston 02114.
authors.forename: L
authors.initials: L
authors.lastname: Quintanilla-Martinez
authors.forename: F
authors.initials: F
authors.lastname: Preffer
authors.forename: D
authors.initials: D
authors.lastname: Rubin
authors.forename: J A
authors.initials: JA
authors.lastname: Ferry
authors.forename: N L
authors.initials: NL
authors.lastname: Harris
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D018951:Antigens, CD20; D000944:Antigens, Differentiation, B-Lymphocyte / Q000032:analysis*; D002471:Cell Transformation, Neoplastic; D005434:Flow Cytometry; D005455:Fluorescent Antibody Technique; D006801:Humans; D016399:Lymphoma, T-Cell / Q000276:immunology* / Q000473:pathology*; D008297:Male; D012016:Reference Values; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000473:pathology*
chemical_list: D015703:Antigens, CD; D018951:Antigens, CD20; D000944:Antigens, Differentiation, B-Lymphocyte