Cytotoxic peripheral T cell lymphoma arising in a patient with nodular lymphocyte predominant Hodgkin lymphoma: a case report
Tóm tắt
In this paper, we describe a case of nodular lymphocyte predominant Hodgkin lymphoma with the subsequent development of a peripheral T cell lymphoma. This case is unusual in that the sheets of atypical and small to intermediate-sized T cells in the diffuse component were CD8 positive and expressed cytotoxic proteins. The diagnosis of peripheral T cell lymphoma was supported by the demonstration of a clonal T cell receptor beta chain gene rearrangement by Southern blot analysis. Peripheral T cell lymphoma with a cytotoxic phenotype is a rare entity with an aggressive clinical behavior. As such, this report emphasizes the need to consider a diagnosis of coexisting peripheral T cell lymphoma in cases of nodular lymphocyte predominant Hodgkin lymphoma with atypical features, such as few or poorly defined B cell macronodules and diffuse T cell areas. The examination of both T cell receptor gamma and beta chain gene rearrangements should be performed to confirm such cases.
Tài liệu tham khảo
Bennett MH, MacLennan KA, Vaughan Hudson G et al (1991) Non-Hodgkin’s lymphoma arising in patients treated for Hodgkin’s disease in the BNLI: a 20-year experience. Ann Oncol 2:83–92
Harris NL (1992) The relationship between Hodgkin’s disease and non-Hodgkin’s lymphoma. Sem Diagn Pathol 9:304–310
Tefferri A, Wiltsie JC, Kurtin PJ (1992) Secondary T-cell lymphoma in the setting of nodular lymphocyte predominance Hodgkin’s disease. Am J Hematol 40:232–233
Rysenga E, Linden MD, Carey JL et al (1995) Peripheral T-cell non-Hodgkin’s lymphoma following treatment of nodular lymphocyte predominant Hodgkin’s disease. Arch Pathol Lab Med 119:88–91
Delabie J, Greiner TC, Chan WC, Weisenburger DD (1996) Concurrent lymphocyte predominance Hodgkin’s disease and T-cell lymphoma: a report of three cases. Am J Surg Pathol 20(3):355–362
Thériault C, Galoin S, Valmary S et al (2000) PCR analysis of immunoglobulin heavy chain (IgH) and TcR-gamma chain gene rearrangements in the diagnosis of lymphoproliferative disorders: results of a study of 525 cases. Mod Pathol 13(12):1269–1279
Greiner TC, Rubocki RJ (2002) Effectiveness of capillary electrophoresis using fluorescent labeled primers in detecting T-cell receptor gamma gene rearrangements. J Mol Diagn 4(3):137–143
Lawnicki LC, Rubocki RJ, Chan WC, Lytle DM, Greiner TC (2003) The distribution of gene segments in T-cell receptor gamma gene rearrangements demonstrates the need for multiple primer sets. J Mol Diagn 5(2):82–87
Beaubier NT, Hart AP, Bartolo C, Willman CL, Viswanatha DS (2000) Comparison of capillary electrophoresis and polyacrylamide gel electrophoresis for the evaluation of T and B cell clonality by polymerase chain reaction. Diagn Mol Pathol 9(3):121–131
Chan WC, Hooper C, Wickert R et al (1993) HTLV-I sequence in lymphoproliferative disorders. Diagn Mol Pathol 2(3):192–199
Baddoura FK, Chan WC, Masih AS, Mitchell D, Sun NC, Weisenburger DD (1995) T-cell-rich B-cell lymphoma. A clinicopathologic study of eight cases. Am J Clin Pathol 103(1):65–75
Asano N, Susuki R, Kagami Y et al (2005) Clinicopathologic and prognostic significance of cytotoxic molecular expression in nodal peripheral T-cell lymphoma, unspecified. Am J Surg Pathol 29(10):1284–1293
Lin P, Medeiros LJ, Wilder RB, Abruzzo LV, Manning JT, Jones D (2004) The activation profile of tumour associated reactive T-cells differs in the nodular and diffuse patterns of lymphocyte predominant Hodgkin’s disease. Histopathology 44(6):561–569
Savage KJ (2005) Aggressive peripheral T-cell lymphomas (specified and unspecified types). Hematology Am Soc Hematol Educ Program 267–277
Prochazka V, Faber E, Raida L et al (2009) Prolonged survival of patients with peripheral T-cell lymphoma after first line intensive sequential chemotherapy with autologous stem cell transplantation. Biomed Pap Med Fac Palacky Univ Olomouc Czech Repub 153(1):63–66