Gastric T-cell lymphoma presenting with epithelioid granulomas mimicking tuberculosis in regional lymph nodes

2001 ◽  
Vol 36 (3) ◽  
pp. 190-194 ◽  
Author(s):  
Masaru Okuno ◽  
Rika Takenaka ◽  
Fusao Kawakami ◽  
Hideki Asakawa ◽  
Motomu Tsuji ◽  
...  
Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3355-3355
Author(s):  
Yeon Hee Park ◽  
Won Seog Kim ◽  
Soo-Mee Bang ◽  
Soon Il Lee ◽  
Ji Eun Uhm ◽  
...  

Abstract Primary gastric lymphoma is the most frequent type of extranodal malignant lymphoma. The large majority of cases are of B-cell lineage, while primary gastric T-cell lymphomas are exceedingly rare and least well characterized malignancy and the clinical features have been described only in a few case reports. In this study, we conducted a retrospective analysis to investigate the natural history and the clinical outcome after treatment. Between 1990 and 2004, 444 patients with primary gastric lymphoma had been diagnosed at four institutes. Among these 444 patients, 17 patients (3.8%) were identified as primary gastric lymphoma with T-cell immunophenotype. The pathologic review was performed by two experienced hematopathologist to confirm T-cell lymphoma with typical immunohistochemical features including CD3. All of the patients were staged according to the Mushoff system. Among these 17 gastirc T-cell lymphoma patients, 14 patients were treated with combination chemotherapy including CHOP with or without radiotherapy. The two patients were treated with high-dose chemotherapy with autologous peripheral hematopoietic stem cell transplantation. The median age of the 13 male and 4 female patients was 49 years (range 22–76 years). The pathologic subtypes of these patients with T-cell immunophenotype were as follows; precursor T-lymphoblastic lymphoma in 2 patients, peripheral T-cell lymphoma, unspecified in 6 patients, NK/T cell lymphoma in 3 patients, and T-cell others in 5 patients. The many of the patients showed poor performance status (PS), and high LDH level (65%). 12 patients (71%) showed stage III or IV diseases, and 9 patients (53%) showed high or high-risk according to the International Prognostic Index (IPI). A response to treatment was observed in 8 patients (47%), with 6 Complete Response (CR) and 2 Partial Response (PR). The median Progression-Free Survival (PFS) and Overall Survival (OS) were only 5 months (95% C.I.; 4–6 months), and 14 months (95% C.I.; 0–189 months). 5 patients of these 17 patients (29%) presented only in stomach and regional lymph nodes. The patients with localized gastric T-cell lymphoma showed good therapeutic outcome (median PFS; 53 months, median OS; 123 months, p =0.024 by log-rank test). Other clinical factors including PS, age, and LDH did not show clinical significance in this series. Although our series had limitation to interpret due to small population, this study showed that the incidence of this subtype of T-cell gastric lymphoma was very rare, and poor prognosis, like as other T-cell lymphoma. However, about 30% of the patients had localized diseases limited to gastric area and regional lymph nodes with relative good prognosis. New therapeutic strategies need to improve the outcome of patients with gastric T-cell lymphoma.


2003 ◽  
Vol 44 (3) ◽  
pp. 525-529 ◽  
Author(s):  
Margarida Lima ◽  
Áurea Canelhas ◽  
Carlos Santos ◽  
Maria dos Anjos Teixeira ◽  
Jorge Coutinho ◽  
...  

2012 ◽  
Vol 57 (No. 5) ◽  
pp. 251-257 ◽  
Author(s):  
I. Otrocka-Domagala ◽  
Z. Procajlo ◽  
K. Pazdzior ◽  
M. Gesek ◽  
T. Rotkiewicz ◽  
...  

Cutaneous epitheliotropic T-cell lymphoma with progression to superficial and internal lymph nodes and the spleen was diagnosed in a two-year-old Holstein-Friesian cow. The skin lesions included multiple hypotrichous to alopecic nodules, often with ulceration, which first appeared three months after calving and progressed quickly to cover the entire body. The cow was euthanized one month later. The ELISA test excluded bovine leukaemia virus infection. Histologically in the epidermis, the formation of Pautrier’s microabscesses and in the dermis, dense neoplastic infiltration with mild folliculotropism was observed. Similar neoplastic cells were present in the histological sections of lymph nodes and spleen. Immunohistochemical analysis was performed using CD3, CD79αcy, HLA-DR, WC1-N3 and Ki67 antibodies. Immunophenotyping results (CD79αcy–, CD3+, WC1-N3–) confirmed the αβ T-cell origin of neoplastic cells. The mean Ki67 index among neoplastic cells was 15.3%. On the basis of the immunohistochemical and histopathological results, the first case in Poland of cutaneous epitheliotropic T-cell lymphoma in a cow was confirmed. Additionally, MHC class II expression on approximately 10.4% of lymphoma cells was associated with a poor clinical prognosis. However, the up-regulation of MHC class II expression on accompanying cells suggested tumour immune surveillance, an antigen-specific immune response or immunosuppression. However, further investigations are needed to confirm these suspicions.  


Blood ◽  
2012 ◽  
Vol 120 (4) ◽  
pp. 812-821 ◽  
Author(s):  
Julia I. Ellyard ◽  
Tiongsun Chia ◽  
Socorro-Maria Rodriguez-Pinilla ◽  
Jaime L. Martin ◽  
Xin Hu ◽  
...  

Abstract Angioimmunoblastic T-cell lymphoma (AITL) is the second most common peripheral T-cell lymphoma with unusual clinical and pathologic features and a poor prognosis despite intensive chemotherapy. Recent studies have suggested AITL derives from follicular helper T (TFH) cells, but the causative molecular pathways remain largely unknown. Here we show that approximately 50% of mice heterozygous for the “san” allele of Roquin develop tumors accompanied by hypergammaglobulinemia by 6 months of age. Affected lymph nodes displayed the histologic features diagnostic of AITL, except for the presence of expanded FDC networks. Accumulation of TFH cells preceded tumor development, and clonal rearrangements in the TCR-β genes were present in most tumors. Furthermore, TFH cells exhibited increased clonality compared with non-TFH cells from the same lymph nodes, even in the absence of tumors. Genetic manipulations that prevent TFH development, such as deletion of ICOS, CD28, and SAP, partially or completely abrogated tumor development, confirming a TFH-derived origin. Roquinsan/+ mice emerge as a useful model to investigate the molecular pathogenesis of AITL and for preclinical testing of therapies aimed at targeting dysregulated TFH cells or their consequences.


2017 ◽  
Vol 45 ◽  
pp. 5
Author(s):  
Carlos Eduardo Fonseca-Alves ◽  
Marina Gabriela Possa ◽  
Fabrício Bernardi ◽  
Helvécio Leal Santos-Junior ◽  
Rômulo Santos Adjuto Eloi ◽  
...  

Background: Canine lymphoma is the most common hematopoietic neoplasm in dogs and reveals divergent biological behaviors correlated to histopathological subtype, the immunophenotypic (T or B) and tumor stage. The multi-centric form is the most common presentation for canine lymphoma, followed by gastrointestinal and cutaneous forms. Miscellaneous forms of canine lymphoma (nasal, osseous, central nervous system and muscle) represent less than 1% of all cases. This report describes the clinical, macroscopic, histopathological and immunohistochemical findings detected in a dog with a primary muscular lymphoma.Case: The subject was referred to the Emergency and Critical Care Service at the Veterinary Hospital with a history of claudication in the left pelvic limb, severe dehydration, hypovolemia, vomiting and diarrhea caused by gastroenteritis associated with the use of phenylbutazone. After death, the post-mortem examination revealed ulcerative gastritis in the gastrointestinal tract (GIT). Histopathological examination of the GIT specimens, mesenteric lymph nodes, and the left popliteal lymph node revealed no neoplastic alterations. Histological examination of semitendinosus muscle revealed proliferation of cells with round or oval nucleus, an evident pleomorphic nucleolus and scanty, eosinophilic cytoplasm. There were five to six mitosis per each 400x field. These cells infiltrated through the muscle fibers. The muscle fibers displayed marked eosinophilic sarcoplasm, loss of striations and fragmentation (degeneration). Immunohistochemical staining revealed negative reaction for CD79a and positive for CD45 and CD3.Discussion: The primary muscle lymphoma it is very rare disease and patients commonly have clinical signs related with muscle location. Our description of muscular primary lymphoma affecting the semitendinosus muscle emphasize that it must be included as a differential diagnosis for dogs with unilateral lameness, inflammatory processes, and other malignancies. In this case, the patient showed an ulcerative gastroenteritis associated with the inappropriate use of phenylbutazone. The patient death was associated with a septicemia due to several ulcers in the gastrointestinal tract. We excluded any regional lymph node involvement and secondary muscular infiltration with post-mortem and histopathological examination. The gross evaluation of the left hind limb demonstrated only muscular involvement (semitendinosus muscle) without infiltration in the adjacent structures, and the histopathology revealed no alteration in the regional lymph node. The immunohistochemical evaluation showed negative staining to CD79a, a high number of positive cells to Ki67 and positive staining to CD45 and CD3. In normal lymph nodes, it was possible to note CD79 diffuse expression in germinal centers in lymphoid follicles and few positive B-lymphocytes in medullary region. Diffuse CD3 expression was found in cortex region by normal Tlymphocytes. There was no histological alterations in sublumbar and popliteal lymph nodes. This immunohistochemical and histological patterns revealed a Peripheral T Cell lymphoma with a high proliferative index. The previous report of primary muscular lymphoma showed a T cell lymphoma with a high proliferative index similar to our findings. Based on macroscopic, histopathological, and immunohistochemical findings it was concluded that the patient had a primary muscular Peripheral T Cell lymphoma.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1299-1299
Author(s):  
Hideharu Muto ◽  
Mamiko Sakata-Yanagimoto ◽  
Yasuyuki Miyake ◽  
Terukazu Enami ◽  
Yuhei Kamada ◽  
...  

Abstract Abstract 1299 Background: Loss-of-function mutations in TET2 are frequent in human myeloid and lymphoid malignancies. Especially, TET2 mutations were found in 30–47% of angioimmunoblastic T-cell lymphoma (AITL) and 10–38% of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS). The tumor origin of AITL is thought to be follicular helper T cells (Tfh). PTCL, NOS is a group of heterogenous T-cell-derived lymphomas, whereas some cases of PTCL, NOS also appear to be derived from Tfh. Several recent papers reported that Tet2 knockout mice demonstrated premalignant status of myeloid lineages, implicating that TET2 mutations have a driver's role in myeloid malignancies; however, there are no clues to how impaired Tet2 function provokes T-cell lymphomas. To address this issue, we analyzed Tet2 gene trap (Tet2gt) mice. Materials and methods: Tet2gt mice (Transgenic Res 17:599, 2008) have a trapping vector inserted into the second intron of Tet2 locus. Lineage-, Sca1+, and c-kit+ (LSK) cells were sorted from Tet2gt E15.5 fetal liver (FL) cells and transplanted into lethally irradiated Ly5.1 wild-type (WT) mice. Bone marrow, spleen, and tumors when developed were analyzed in the recipient mice as well as adult Tet2gtmice by flow cytometory and immunohistochemical staining. Result: Adult Tet2gt mice were obtained under the following ratio; Tet2+/+:Tet2+/gt:Tet2gt/gt=48:52:25. TET2 mRNA expression level in Tet2gt/gt Lin- FL cells was reduced to 20% of that in WT Lin- FL cells, while the 5-hydroxymethyl cytosine level was reduced to around a half of that in WT cells. At 40 weeks of age, the proportion of CD4+/PD1+/Cxcr5+ cells, immunophenotypically similar to Tfh cells, significantly increased in Tet2gt/gt mice compared to WT mice (P=0.022). Two out of 8 Tet2gt/gt mice developed marked splenomegaly (more than 300 mg) at 40 weeks, and 4 out of 6 developed marked splenomegaly with swollen lymph nodes and multi-nodular tumors in liver and lungs at 60 weeks or older (median, 67 weeks). Histological examination of the enlarged spleen and swollen lymph nodes in these 4 mice demonstrated completely destroyed follicular structures. The spleen, lymph nodes, and nodular tumors showed infiltration of morphologically abnormal lymphocytes, which were proven to be CD4+/PD1+ T cells. These cells were also weakly positive for Cxcr5. CD4+ cells purified from the tumors revealed restricted rearrangement patterns of T-cell receptor genes, implying T-cell lymphoma. There were no increased vascular structures representing AITL. CD4+/PD1+ cells purified from the tumors expressed Bcl6 and cMaf, two key transcription factors of Tfh, at significantly higher levels compared to CD4+/PD1+ cells purified from spleen of WT mice. Meanwhile, one of 6 mice transplanted with Tet2gt/gt LSK cells also developed lymphoma with similar pattern of CD4+/PD1+/CXCR5 expression at 40 weeks after transplantation. Discussion: Our observations indicate that reduced expression of TET2 may cause skewed differentiation into Tfh, which eventually develop tumors that pathologically recapitulate PTCL, NOS in human, while the tumor-comprising cells show characteristics of Tfh. The long latency period required for tumor development indicates secondary genetic hits in addition to the downregulation of TET2. These secondary events might determine the specificity of the hematologic malignancies, particularly AITL and PCTL, NOS with propensity for AITL. Disclosures: No relevant conflicts of interest to declare.


2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 8047-8047 ◽  
Author(s):  
E. Kim ◽  
A. Rook ◽  
Y. Kim ◽  
M. Demierre ◽  
A. Lerner ◽  
...  

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