title: Peripheral T-cell lymphoma mimicking marginal zone B-cell lymphoma.
abstract: Peripheral T-cell lymphoma (PTCL) may assume a variety of histologic and cytologic appearances. We describe eight cases of PTCL morphologically simulating marginal zone B-cell lymphoma. We reviewed PTCL cases diagnosed in our institution between 1990 and 2000 and selected eight cases for study based on the following criteria: small-cell morphology with abundant, clear cytoplasm and either marginal zone involvement by the neoplastic infiltrate in lymph node biopsies or lymphoepithelial lesions in extranodal biopsies. Histologic features and ancillary studies were reviewed. Patients included six women and two men with a median age of 53 years (range, 35 to 74 years). Six patients were diagnosed with primary nodal PTCL, and two presented with primary extranodal disease. The original diagnosis was PTCL in only four cases; three cases were diagnosed as atypical lymphoid infiltrate, and one case as benign lymphoepithelial lesion. Lymph node biopsies revealed partial effacement of the architecture with residual follicles surrounded by the neoplastic small cells. Extranodal sites included hard palate, tongue, tonsil, and submandibular glands; all but one case demonstrated lymphoepithelial lesions. Monoclonality was demonstrated in six of eight cases (rearrangement of T-cell receptor gene), and three of eight had an aberrant T-cell population by flow cytometry. The differential diagnosis of atypical lymphoid infiltrates with morphologic features of marginal zone B-cell lymphoma should include PTCL. This uncommon morphological mimicry should be recognized, because PTCL is an aggressive disease regardless of morphology and should be treated accordingly.
authors.affiliation: Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109-0602, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Uherova
authors.forename: Charles W
authors.initials: CW
authors.lastname: Ross
authors.forename: William G
authors.initials: WG
authors.lastname: Finn
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Singleton
authors.forename: Rina
authors.initials: R
authors.lastname: Kansal
authors.forename: Bertram
authors.initials: B
authors.lastname: Schnitzer
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D018951:Antigens, CD20 / Q000032:analysis; D017252:CD3 Complex / Q000032:analysis; D051925:CD79 Antigens; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D005838:Genotype; D006801:Humans; D007150:Immunohistochemistry; D017493:Leukocyte Common Antigens / Q000032:analysis; D051917:Leukosialin; D016393:Lymphoma, B-Cell / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011947:Receptors, Antigen, B-Cell / Q000032:analysis; D011948:Receptors, Antigen, T-Cell / Q000235:genetics; D012795:Sialoglycoproteins / Q000032:analysis
chemical_list: D015703:Antigens, CD; D018951:Antigens, CD20; D017252:CD3 Complex; D051925:CD79 Antigens; C497881:CD79A protein, human; D051917:Leukosialin; D011947:Receptors, Antigen, B-Cell; D011948:Receptors, Antigen, T-Cell; C465014:SPN protein, human; D012795:Sialoglycoproteins; D017493:Leukocyte Common Antigens