Clinicopathologic analysis of 6 lymphomatoid gastropathy cases: expanding the disease spectrum to CD4-CD8+ cases.
Lymphomatoid gastropathy, which was first reported in 2010, is a rare NK-cell proliferation of cyCD3, CD4, CD5, CD8, CD56 phenotypes with unknown etiology. The diagnosis is challenging, as there is histopathologic similarity to malignant lymphoma. In the 2010 report on 10 cases, all lesions were located in the stomach, and all regressed without any therapy. In the present study, we analyzed 6 cases of lymphomatoid gastropathy by investigating the clinicopathologic, immunohistochemical, and molecular findings. Endoscopic and morphologic appearances of all cases were consistent with previous reports, but 2 cases showed previously unreported unique immunophenotypes of CD4CD8. Three of 6 patients underwent lower gastrointestinal examination (1 case underwent double-balloon endoscopic examination), but no patient had lesions in the lower gastrointestinal tract. No obvious difference of histology was found between the cases of CD4-CD8-typical phenotype and ones of CD4CD8 phenotype. Both cases had similar clinical behavior as the other 4 cases, implying that the spectrum of the disease is broader than initially thought. Careful clinical and endoscopic follow-up is required for the diagnosis of lymphomatoid gastropathy, and additional case studies and molecular studies are warranted to further investigate the pathophysiology of this peculiar benign mimic of lymphoma.
Departments of *Pathology ††Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama †Department of Pathology, Hiroshima City Hiroshima Citizens Hospital ∥Department of Pathology, Chuden Hospital, Hiroshima ‡Department of Computational Science and Engineering, Graduate School of Engineering, Nagoya University, Nagoya §Department of Pathology, National Hospital Organization Kochi National Hospital, Kochi ¶Department of Gastroenterology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima Departments of #Hematology **Laboratory Medicine and Pathology, Chugoku Central Hospital, Fukuyama ‡‡Department of Anatomic Pathology, Kagawa Rosai Hospital, Marugame, Japan.
Katsuyoshi
K
Takata
Mai
M
Noujima-Harada
Tomoko
T
Miyata-Takata
Koichi
K
Ichimura
Yasuharu
Y
Sato
Takafumi
T
Miyata
Keishi
K
Naruse
Toshiyuki
T
Iwamoto
Akira
A
Tari
Taro
T
Masunari
Hiroshi
H
Sonobe
Hiroyuki
H
Okada
Masaya
M
Iwamuro
Kohichi
K
Mizobuchi
Yuka
Y
Gion
Tadashi
T
Yoshino
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D015704:CD4 Antigens / Q000032:analysis*; D016827:CD8 Antigens / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017403:In Situ Hybridization; D007694:Killer Cells, Natural / Q000276:immunology* / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology
D014408:Biomarkers, Tumor; D015704:CD4 Antigens; D016827:CD8 Antigens