Indolent T-lymphoblastic proliferation: report of a case with an 11-year history and association with myasthenia gravis.
T-lymphoblastic lymphoma is a high-grade malignant lymphoma with frequent occurrence in young males, mediastinal involvement, and systemic dissemination. Indolent T-lymphoblastic proliferations have rarely been recognized. In the present case, we report on an indolent T-lymphoblastic proliferation involving the oropharynx in a patient with myasthenia gravis with multiple local recurrences over an 11-year period without evidence of systemic dissemination. The T-lymphoblasts were consistently positive for terminal deoxynucleotidyl transferase (TdT), CD1, CD3, CD4, and CD8, corresponding to an intermediate thymocyte stage of differentiation. No cytokeratin-positive thymic epithelial cells were identified, ruling out an ectopic thymus or thymoma. T-receptor gene rearrangement studies by Southern blot revealed no monoclonal CT-beta rearrangement. Indolent T-lymphoblastic proliferations of undetermined clonality may rarely occur; predilection for involvement of oropharynx and possible association with myasthenia gravis are suggested.
Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. james.strauchen@mssm.edu
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D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D000951:Antigens, Neoplasm / Q000378:metabolism; D004253:DNA Nucleotidylexotransferase; D004273:DNA, Neoplasm / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008297:Male; D009157:Myasthenia Gravis / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D009960:Oropharynx / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000378:metabolism / Q000473:pathology*
D015703:Antigens, CD; D000951:Antigens, Neoplasm; D004273:DNA, Neoplasm; D004253:DNA Nucleotidylexotransferase