title: Relationship between atypical T- and B-cell size predicts survival in peripheral T-cell lymphomas with large B-cells.
abstract: Pathological prognostication for peripheral T-cell lymphomas (PTCLs) complicated by large B-cell (LBC) proliferations has not been previously devised.
  
  
  
  Forty-six cases of PTCL with LBCs were reviewed immunohistologically, by in situ hybridisation for Epstein-Barr virus encoded RNA and polymerase chain reaction analyses for T-cell receptor (TCR) clonality. Follow-up intervals ranged from 1 to 149 months (mean 40 months).
  
  
  
  Cases with atypical T-cell size equal to or exceeding that of interspersed LBCs (ATEB+, n = 12, including an ALK negative anaplastic large cell lymphoma) had significantly inferior disease-specific survival compared to ATEB negative (ATEB-, n = 34) cases (p = 0.002 for all cases and p = 0.014 when restricted to TCR clonal cases, n = 30) [hazard ratio 11.2; 95% confidence interval (CI) 0.94-85.0, p = 0.019]. All recorded deaths amongst ATEB+ cases occurred in 26 months, while TCR polyclonal ATEB- cases (n = 9) had none; TCR clonal ATEB- cases (n = 22) had 62% 5-year survival (95% CI 33-91%, p = 0.001). There was no survival separation between angioimmunoblastic (n = 25) and unspecified (n = 20) subsets of PTCL (p = 0.957).
  
  
  
  In PTCLs, cytological grading using harboured LBCs as internal yardsticks, as well as molecular genotypic measures of lymphoma cell burden, have prognostic value.
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore. leonard.tan.h.c@sgh.com.sg
authors.forename: Leonard Hwan Cheong
authors.initials: LH
authors.lastname: Tan
authors.forename: Soo Yong
authors.initials: SY
authors.lastname: Tan
authors.forename: Tiffany
authors.initials: T
authors.lastname: Tang
authors.forename: Soon Thye
authors.initials: ST
authors.lastname: Lim
authors.forename: Daryl
authors.initials: D
authors.lastname: Tan
authors.forename: Lay Cheng
authors.initials: LC
authors.lastname: Lim
authors.forename: Grace Li Shan
authors.initials: GL
authors.lastname: Kam
authors.forename: Yeh Ching
authors.initials: YC
authors.lastname: Linn
authors.forename: Tze Ping
authors.initials: TP
authors.lastname: Loh
authors.forename: Miriam
authors.initials: M
authors.lastname: Tao
authors.forename: Evelyn Siew Chuan
authors.initials: ES
authors.lastname: Koay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D049109:Cell Proliferation; D048429:Cell Size; D002999:Clone Cells; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015329:Gene Rearrangement, T-Lymphocyte; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D016130:Immunophenotyping; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D011948:Receptors, Antigen, T-Cell / Q000235:genetics / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D011948:Receptors, Antigen, T-Cell