Extranodal multiple involvement of enteropathy-type T-cell lymphoma without expression of CC chemokine receptor 7.
Enteropathy-type T-cell lymphoma (ETCL) is a rare extranodal lymphoma that tends to disseminate into the intestines and other extranodal organs. We present a case of ETCL with involvement of the lungs and kidneys and report CC chemokine receptor 7 (CCR7) expression of lymphoma cells. A 73-year-old man was admitted to the hospital with a complaint of abdominal pain. Multiple ulcers and perforations were observed in the small intestine, and partial resection of the ileum was performed. Histological examination of the resected specimen revealed diffuse proliferation of atypical large lymphoid cells. The diagnosis was ETCL with dissemination into the lungs and kidney. Lymphoma cells of the small intestine and in pleural effusion were CD3+, CD4+, CD7+, CD8-, CD25-, CD56-, CD103 +/-, and TIA-1+. Rearrangement of the T-cell receptor beta gene was detected, and human T-lymphotropic virus was not integrated. Combination chemotherapy did not result in a sustained response. The results for CCR7 expression of lymphoma cells in the lung and pleural effusion were negative. Therefore we concluded that lymphoma cells did not migrate into the lymph nodes but instead spread into the extranodal organs.
Division of Clinical Immunology, Department of Immunobiology and Neuroscience, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan. mshira@tsurumi.beppu.kyushu-u.ac.jp
Motoaki
M
Shiratsuchi
Youko
Y
Suehiro
Yasuji
Y
Yoshikawa
Koichi
K
Ohshima
Satoshi
S
Shiokawa
Junji
J
Nishimura
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002465:Cell Movement; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D016130:Immunophenotyping; D007413:Intestinal Mucosa / Q000473:pathology; D007414:Intestinal Neoplasms / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D009361:Neoplasm Invasiveness; D014411:Neoplastic Stem Cells / Q000473:pathology; D009928:Organ Specificity; D010996:Pleural Effusion / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D054400:Receptors, CCR7; D019707:Receptors, Chemokine; D016176:T-Lymphocyte Subsets / Q000473:pathology; D014750:Vincristine / Q000008:administration & dosage; D014781:Viscera / Q000473:pathology
C515370:CCR7 protein, human; D054400:Receptors, CCR7; D019707:Receptors, Chemokine; D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D011241:Prednisone; D008775:Methylprednisolone