title: Angioimmunoblastic T-cell lymphoma with hyperplastic germinal centres (pattern 1) shows superior survival to patterns 2 and 3: a meta-analysis of 56 cases.
abstract: OBJECTIVE
  Angioimmunoblastic T-cell lymphoma (AITL) may present in patterns 1, 2 or 3, representing those with hyperplastic, regressed or effaced germinal centres (GCs), respectively, but the prognostic utility of this subclassification has not been previously validated.
  
  
  RESULTS
  Twenty-five cases of AITL were reviewed immunohistologically and with in-situ hybridization for Epstein-Barr virus-encoded RNA and polymerase chain reaction for T-cell receptor gamma and immunoglobulin heavy chain clonality and followed for up to 120 months. Four cases had conventional hyperplastic GCs, two had floral GCs, and one had progressively transformed GCs, consistent with pattern 1 and one additional case had hyalinized GCs, consistent with pattern 2. The remaining 17 (pattern 3) cases lacked morphologically discernible GCs. The Kaplan-Meier survival distribution of pattern 1 cases (5-year survival 83%) was superior to that of pattern 2 and 3 cases [5-year-survival 36% (P = 0.0417)] only when combined with the 31 cases, seven of which were pattern 1, that Attygalle et al. had followed for up to 247 months and previously published. Furthermore, the development of B-lineage (classical Hodgkin or diffuse large-cell) lymphoma was associated exclusively with pattern 3 (P = 0.0057).
  
  
  CONCLUSIONS
  Pattern 1 represents an indolent phase/grade of AITL, unassociated with the development of secondary B-lineage lymphoma and uninfluenced by treatment regimen.
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore. leonard.tan.h.c@sgh.com.sg
authors.forename: Leonard H C
authors.initials: LH
authors.lastname: Tan
authors.forename: Soo Y
authors.initials: SY
authors.lastname: Tan
authors.forename: Tiffany
authors.initials: T
authors.lastname: Tang
authors.forename: Soon T
authors.initials: ST
authors.lastname: Lim
authors.forename: Daryl
authors.initials: D
authors.lastname: Tan
authors.forename: Lay C
authors.initials: LC
authors.lastname: Lim
authors.forename: Grace L S
authors.initials: GL
authors.lastname: Kam
authors.forename: Tze P
authors.initials: TP
authors.lastname: Loh
authors.forename: Miriam
authors.initials: M
authors.lastname: Tao
authors.forename: Evelyn S C
authors.initials: ES
authors.lastname: Koay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018858:Germinal Center / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia / Q000401:mortality / Q000473:pathology; D007119:Immunoblastic Lymphadenopathy / Q000401:mortality* / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate