Indolent T-lymphoblastic proliferation: report of a case with a 16-year course without cytotoxic therapy.
T-lymphoblastic lymphoma is a high-grade malignant lymphoma. Clinically indolent T-lymphoblastic proliferations have not been described. We present a case report of an indolent T-cell lymphoblastic proliferation studied by histopathology, immunohistochemistry, flow cytometry, antigen receptor gene rearrangement studies, and cytogenetics. The patient had recurrent masses in the upper aerodigestive tract over a 16-year period, was treated by multiple surgical excisions, and never received either chemotherapy or radiotherapy. A proliferation of lymphoblasts was present histologically. The cells were positive for terminal deoxynucleotidyl transferase, CD1, and CD3, and coexpressed CD4 and CD8. No clonal rearrangements of the T-cell receptor beta or gamma chain genes were identified. Cytogenetic studies revealed a questionable inversion of the short arm of chromosome 9, affecting the 9p21-22 region. Although ectopic thymic tissue was considered, the case was considered to be an indolent lymphoblastic proliferation. It should be recognized that rare lymphoblastic proliferations may not behave in a high grade fashion as typically seen in T-lymphoblastic lymphoma.
Velankar
M M
MM
Department of Pathology, University of Southern California School of Medicine, USA.
Nathwani
B N
BN
Schlutz
M J
MJ
Bain
L A
LA
Arber
D A
DA
Slovak
M L
ML
Weiss
L M
LM
D000328:Adult; D004273:DNA, Neoplasm / Q000032:analysis; D005434:Flow Cytometry; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000235:genetics* / Q000276:immunology / Q000473:pathology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000276:immunology / Q000473:pathology*; D011946:Receptors, Antigen / Q000235:genetics; D013601:T-Lymphocytes / Q000378:metabolism / Q000473:pathology*
D004273:DNA, Neoplasm; D011946:Receptors, Antigen