TIA-1+ cytotoxic large T-cell lymphoma of the mediastinum: case report.
A 52-year-old previously healthy Caucasian woman presented with superior vena cava syndrome, secondary to compression of a bulky anterior mediastinal mass involving the right lung. Fine-needle aspiration biopsy of the mediastinum yielded large epithelioid cells intermingled with small mature lymphocytes. The epithelioid cells are LCA positive, expressing cytoplasmic CD3 diffusely and TIA-1 focally, but negative for EMA, CD4, CD8, CD15, CD20, CD30, and CD56. The TIA-1+ cytoplasmic granules correlated to the azurophilic granules in Diff-Quik-stained cells, pink granules in Ultrafast Papanicolaou-stained cells, and dense core granules in electron microscopy. In situ hybridization for Epstein-Barr viral RNA was negative. The background small lymphocytes were composed of a majority of CD4+ T-lymphocytes and minority of CD8+ T-lymphocytes. The patient responded well to six cycles of CHOP chemotherapy, followed by radiation with a total dose of 4140 cGy delivered to the mediastinum in 23 fractions. On the chest X-ray taken 6 mo later, there was minimal apical fibrosis with no evidence of an acute intrathoracic pathology. To the best of our knowledge, this case may be the first report of cytotoxic large T-cell lymphoma of the mediastinum.
Yang
Grace C H
GC
Department of Pathology, Medical Center, New York University School of Medicine, New York, NY 10016, USA. grace.yang@nyu.edu
Yee
Herman T
HT
Wu
C Daniel
CD
Aye
Lwin M
LM
Chachoua
Abraham
A
D001707:Biopsy, Needle; D003594:Cytoplasmic Granules / Q000737:chemistry / Q000378:metabolism / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*; D016411:Lymphoma, T-Cell, Peripheral / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*; D008479:Mediastinal Neoplasms / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*; D008565:Membrane Proteins / Q000032:analysis / Q000096:biosynthesis*; D008875:Middle Aged; D009367:Neoplasm Staging; D039102:Poly(A)-Binding Proteins; D011506:Proteins; D016601:RNA-Binding Proteins / Q000032:analysis / Q000096:biosynthesis*; D000074019:T-Cell Intracellular Antigen-1; D013602:T-Lymphocytes, Cytotoxic / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*
D008565:Membrane Proteins; D039102:Poly(A)-Binding Proteins; D011506:Proteins; D016601:RNA-Binding Proteins; D000074019:T-Cell Intracellular Antigen-1; C071558:TIA1 protein, human