title: Lymph node lesion in adult-onset Still's disease resembling peripheral T-cell lymphoma: a report of three cases.
abstract: Adult-onset Still's disease (AOSD) is known to be a cause of fever of unknown origin. We describe the clinicopathologic, immunohistologic, and genotypic features of 3 patients with lymph node lesions from AOSD, which posed a serious diagnostic difficulty from peripheral T-cell lymphomas. The patients were 22-, 26-, and 63-year-old Japanese women. At the onset of disease, all patients had multicentric lymphadenopathy in association with clinical and laboratory findings suggestive of a malignant lymphoma. None of the patients developed malignant lymphomas during the follow-up period. Histologically, the lesions were characterized by paracortical hyperplasia with prominent vascular proliferation. In the paracortical area, there was a mixed infiltrate including small-to-medium-sized lymphocytes, variable numbers of eosinophils, plasma cells, and B immunoblasts. Polymerase chain reaction analysis demonstrated that neither clonal rearrangement of the T-cell receptor gamma-chain gene nor immunoglobulin heavy-chain rearrangement was detected in any patient. Although AOSD appears to be a rare systemic inflammatory disorder, the lymph node lesion should be added to the differential consideration of benign lymph node lesions simulating node-based peripheral T-cell lymphoma.
authors.affiliation: Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Takabayashinishi-cho Ohta, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kojima
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Shyuichi
authors.initials: S
authors.lastname: Miyawaki
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Yashiro
authors.forename: Tetsunari
authors.initials: T
authors.lastname: Oyama
authors.forename: Hideaki
authors.initials: H
authors.lastname: Itoh
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sakata
authors.forename: Shiro
authors.initials: S
authors.lastname: Sugihara
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Masawa
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D004247:DNA / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D008206:Lymphatic Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D016411:Lymphoma, T-Cell, Peripheral / Q000473:pathology*; D008875:Middle Aged; D016706:Still's Disease, Adult-Onset / Q000150:complications / Q000378:metabolism / Q000473:pathology*
chemical_list: D015703:Antigens, CD; D004247:DNA