title: Paediatric T-cell lymphoma of the appendix: a case report.
abstract: A 7-year-old boy with no history of malnutrition or diarrhoea complained of acute abdominal pain, was diagnosed with acute appendicitis, and underwent appendectomy. Histologically, a diffuse infiltrate of large atypical lymphoid cells was found in the entire appendiceal wall. Immunohistochemical examination revealed that the tumour cells expressed T-cell receptor (TCR)-βF1, CD3, CD4, CD25, cytotoxic-related protein TIA1 and granzyme-B, but were negative for CD8, Foxp3, CD20, CD30 and CD56. Polymerase chain reaction (PCR) revealed clonal bands of TCR-γ gene products in the tumour tissue. No anti-cytomegalovirus antibody-positive cells were detected. In situ hybridization revealed no nuclear signals of Epstein-Barr virus (EBV)-encoded RNA. Helicobacter pylori infection was detected in tumour tissue by anti-East Asian cytotoxin-associated gene (Cag) A antibody and PCR using its specific primers. The patient received chemotherapy and has remained in remission for 2 years. To the best of our knowledge, only two cases of appendiceal T-cell non-Hodgkin lymphoma (NHL) have been reported, both in elderly patients. We believe that this is the first reported case of childhood CD4- and TIA1-positive cytotoxic T (Th1)-cell NHL in the appendix or gastrointestinal tract. Helicobacter pylori infection might be an initiator of atypical cytotoxic T-cell proliferation.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1302380563830412.
authors.affiliation: Laboratory of Pathology, Chidoribashi Hospital, 5-18-1 Chiyo, Fukuoka 812-8633, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Matsushita
authors.forename: Morishige
authors.initials: M
authors.lastname: Takeshita
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D001062:Appendectomy; D001063:Appendiceal Neoplasms / Q000737:chemistry / Q000150:complications / Q000235:genetics / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D001064:Appendicitis / Q000209:etiology; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D017024:Chemotherapy, Adjuvant; D002648:Child; D019675:Genes, T-Cell Receptor gamma; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007150:Immunohistochemistry; D016399:Lymphoma, T-Cell / Q000737:chemistry / Q000150:complications / Q000235:genetics / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D016133:Polymerase Chain Reaction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor