TdT+ T-lymphoblastic populations are increased in Castleman disease, in Castleman disease in association with follicular dendritic cell tumors, and in angioimmunoblastic T-cell lymphoma.
T-lymphoblastic lymphoma is an aggressive neoplasm requiring prompt clinical treatment. Conversely, indolent T-lymphoblastic proliferation mimics T-lymphoblastic lymphoma but consists of a proliferation of non-neoplastic TdT+ T cells, requiring no treatment. Recently, we identified several cases of indolent T-lymphoblastic proliferations in extrathymic lymphoid tissues: 1 in a patient suffering from Castleman disease (CD) associated with a follicular dendritic cell sarcoma/tumor, 1 in a patient with a history of angioimmunoblastic T-cell lymphoma (AITL), and 1 in association with acinic cell carcinoma. Interestingly, in the case of the patient with a history of AITL, these TdT+ T cells were seen in multiple anatomic sites over the span of 5 years. Here we review these 3 cases and extend our findings by demonstrating that TdT+ T-lymphoblastic populations are increased in lymph nodes of patients with CD (P=0.011), CD in association with follicular dendritic cell tumors, and AITL (P<0.01) compared with other T-cell or B-cell lymphomas or reactive lymph nodes. Finally, analysis of 352 nonhematolymphoid tumors including carcinomas, melanomas, and sarcomas demonstrates that TdT+ T cells are not increased in these tumors. Our studies not only present several detailed cases of indolent T-lymphoblastic proliferations, but also correlate these populations with specific hematologic diseases.
Department of Pathology, Stanford University, CA 94305, USA. rohgami@stanford.edu
Robert S
RS
Ohgami
Shuchun
S
Zhao
Jane K
JK
Ohgami
Matthew O
MO
Leavitt
James L
JL
Zehnder
Robert B
RB
West
Daniel A
DA
Arber
Yasodha
Y
Natkunam
Roger A
RA
Warnke
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005871:Castleman Disease / Q000378:metabolism / Q000473:pathology*; D049109:Cell Proliferation; D004253:DNA Nucleotidylexotransferase / Q000378:metabolism*; D054740:Dendritic Cell Sarcoma, Follicular / Q000378:metabolism / Q000473:pathology*; D003713:Dendritic Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000378:metabolism / Q000473:pathology*; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D046888:Tissue Array Analysis; D055815:Young Adult
D004253:DNA Nucleotidylexotransferase