Adult T-cell lymphoma/leukemia with angioimmunoblastic T-cell lymphomalike features: Report of 11 cases.
In adult T-cell lymphoma/leukemia (ATLL), the neoplastic lymphoid cells are usually medium-sized to large, often with pronounced nuclear pleomorphism compatible with the diagnosis of diffuse pleomorphic peripheral T-cell lymphoma. We describe here 11 patients with the rare morphologic variant of ATLL, angioimmunoblastic T-cell lymphoma (AILT)-like type. The examined lymph nodes showed proliferation of high endothelial venules and presence of various infiltrating inflammatory cells including plasma cells and eosinophils. The lymphoma cells were medium-to-large size with clear cytoplasm. These findings were suggestive of AILT. However, immunohistochemical features of AILT, namely, CD10 and CXCL13 expression in lymphoma cells and proliferation of CD21-positive follicular dendritic cells, were not detected. Two cases were CXCR3-positive, whereas 9 expressed CCR4, which are usually positive in ATLL. All patients were positive for antiadult T-cell leukemia/lymphoma-associated antigen, which is a specific antibody for human T-cell lymphotropic virus type-I. Southern blot analysis revealed proviral DNA integration in lymphoma cells in 9 patients. The latter was not evident in the first biopsy of 2 patients but in the second biopsy obtained within several months after the first biopsy revealed definite proviral integration. Almost all patients showed aggressive clinical course and poor survival (median survival: 5 mo). This is the first report of ATLL with AILT-like morphologic features.
Karube
Kennosuke
K
Department of Pathology, School of Medicine, Kurume University, Kurume, Japan. karube1975@yahoo.co.jp
Suzumiya
Junji
J
Okamoto
Masataka
M
Takeshita
Morishige
M
Maeda
Koichi
K
Sakaguchi
Mamoru
M
Inada
Tomohisa
T
Tsushima
Hideki
H
Kikuchi
Masahiro
M
Ohshima
Koichi
K
D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015490:HTLV-I Infections / Q000821:virology; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
D015703:Antigens, CD; D014408:Biomarkers, Tumor; D004279:DNA, Viral