title: Nodal cytotoxic lymphoma spectrum: a clinicopathologic study of 66 patients.
abstract: The expression of cytotoxic granule-associated proteins has been reported in some T-cell or natural killer (NK)-cell lymphomas of mostly extranodal origin, but rarely of nodal origin except for anaplastic large cell lymphoma (ALCL) and Hodgkin's disease (HD). This study analyzed 66 nodal lymphomas expressing T-cell intracellular antigen-1 (TIA-1) and/or granzyme B to characterize the clinicopathologic spectrum of these neoplasms. Four main groups could be delineated. The first group consisted of p80/anaplastic lymphoma kinase (ALK)-positive ALCL (n = 35). The patients were 2 to 62 years of age (median age, 16 years), and the lymphomas pursued a relatively indolent clinical course. The tumors were phenotypically of either T- or null-cell type with constant expression of CD30, epithelial membrane antigen (EMA), and p80/ALK, but not CD15 or BCL2. None harbored Epstein-Barr virus (EBV). The second group consisted of peripheral T/NK-cell lymphoma, the nodal high-grade cytotoxic type (n = 13). The patients were 29 to 72 years in age (median age, 55 years), and the tumors pursued an aggressive clinical course. The tumors often showed pleomorphic, anaplastic, or centroblastoid morphology, and were featured by either EBV association or CD56 expression. The third group consisted of peripheral T-cell lymphoma, of the nodal low-grade cytotoxic type (n = 8). The patients, three men and five women, were 31 to 75 years old (median age, 61 years). Notably, six of them exhibited lymphoepithelioid (Lennert's) lymphoma. The fourth group consisted of cytotoxic Hodgkin's-like ALCL/HD (n = 10), included seven cases of Hodgkin's-like ALCL and three cases of HD, and was characterized by the presence of Reed-Sternberg cells and often the CD15+ phenotype. The patients were all men except for one woman, and they ranged in age from 24 to 84 years (median age, 62 years). The link among these four groups was reinforced by the presence of a highly characteristic large cell with horseshoelike or reniform nuclei-the frequent expression of CD30 and EMA-and the often lack of T-cell receptor-alphabeta. In this series, the expression of p80/ALK and CD56 was also associated with favorable and poor prognoses respectively (p<0.001, log-rank test).
authors.affiliation: Department of Hematology and Chemotherapy, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kagami
authors.forename: R
authors.initials: R
authors.lastname: Suzuki
authors.forename: H
authors.initials: H
authors.lastname: Taji
authors.forename: Y
authors.initials: Y
authors.lastname: Yatabe
authors.forename: T
authors.initials: T
authors.lastname: Takeuchi
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: E
authors.initials: E
authors.lastname: Kondo
authors.forename: M
authors.initials: M
authors.lastname: Kojima
authors.forename: T
authors.initials: T
authors.lastname: Motoori
authors.forename: Y
authors.initials: Y
authors.lastname: Mizoguchi
authors.forename: M
authors.initials: M
authors.lastname: Okamoto
authors.forename: K
authors.initials: K
authors.lastname: Ohnishi
authors.forename: H
authors.initials: H
authors.lastname: Yamabe
authors.forename: M
authors.initials: M
authors.lastname: Seto
authors.forename: M
authors.initials: M
authors.lastname: Ogura
authors.forename: T
authors.initials: T
authors.lastname: Koshikawa
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Kurita
authors.forename: Y
authors.initials: Y
authors.lastname: Morishima
authors.forename: T
authors.initials: T
authors.lastname: Suchi
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000378:metabolism; D019002:CD56 Antigen / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D019309:Epstein-Barr Virus Nuclear Antigens / Q000032:analysis; D005260:Female; D053804:Granzymes; D006689:Hodgkin Disease / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D015458:Leukemia, T-Cell / Q000145:classification / Q000378:metabolism / Q000473:pathology; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000378:metabolism / Q000473:pathology*; D016411:Lymphoma, T-Cell, Peripheral / Q000145:classification / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D008875:Middle Aged; D039102:Poly(A)-Binding Proteins; D011505:Protein-Tyrosine Kinases / Q000378:metabolism*; D011506:Proteins; D016601:RNA-Binding Proteins / Q000378:metabolism*; D020794:Receptor Protein-Tyrosine Kinases; D012697:Serine Endopeptidases / Q000378:metabolism*; D000074019:T-Cell Intracellular Antigen-1
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen; D019309:Epstein-Barr Virus Nuclear Antigens; D008565:Membrane Proteins; D039102:Poly(A)-Binding Proteins; D011506:Proteins; D016601:RNA-Binding Proteins; D000074019:T-Cell Intracellular Antigen-1; C071558:TIA1 protein, human; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases; C509213:GZMB protein, human; D053804:Granzymes; D012697:Serine Endopeptidases