title: Primary gastric apoptosis-rich T-cell lymphoma co-expressing CD4, CD8, and cytotoxic molecules.
abstract: In contrast to primary gastric lymphomas of B-cell type, little is known about primary gastric T-cell lymphomas. We describe three cases with remarkably similar features: diffuse growth, epitheliotropism, medium too large cell size, high apoptotic rates, and a CD3+, CD4+, CD8+, CD45RO+ immunophenotype. Clonal TCRgamma gene rearrangement was shown in two cases. Epstein-Barr virus infection was excluded in two cases. Taking advantage of fresh-frozen material, we analyzed two cases further, revealing CD5-, CD16+, CD56-, CD57-, CD25+, CD30+, CD103 (alphaEbeta7)+, bcl-2 protein+, CD95+, CD95 ligand(L)-. CD95L, however, was detected in histiocytic and fibroblastoid by stander cells. The lymphomas expressed granzyme B, perforin, and the TIA-1 antigen in various combinations. All three cases had a very unfavorable clinical course characterized by local recurrence and/or dissemination to other epithelial sites, leading to death within 6-12 months after the initial diagnosis despite surgery and aggressive antineoplastic treatment. These data suggest a novel variant of peripheral T-cell lymphoma operationally characterized as primary gastric, apoptosis-rich, CD103+, EBV-, T-cell lymphoma co-expressing CD4, CD8, CD16 and cytotoxic molecules.
authors.affiliation: Pathologisches Institut der Universität Ulm, Germany.
authors.forename: T F
authors.initials: TF
authors.lastname: Barth
authors.forename: F
authors.initials: F
authors.lastname: Leithäuser
authors.forename: H
authors.initials: H
authors.lastname: Döhner
authors.forename: M
authors.initials: M
authors.lastname: Bentz
authors.forename: M
authors.initials: M
authors.lastname: Pawlita
authors.forename: U
authors.initials: U
authors.lastname: Schmid
authors.forename: P
authors.initials: P
authors.lastname: Möller
mesh_terms: D000328:Adult; D017209:Apoptosis; D015704:CD4 Antigens / Q000378:metabolism*; D016827:CD8 Antigens / Q000378:metabolism*; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D016399:Lymphoma, T-Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics; D013274:Stomach Neoplasms / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D015704:CD4 Antigens; D016827:CD8 Antigens; D016692:Receptors, Antigen, T-Cell, gamma-delta