scholarly journals An Unusual Case of Hepatosplenic αβ T-Cell Lymphoma Presenting with Coombs'-Negative Hemolytic Anemia

2015 ◽  
Vol 9 ◽  
pp. CMO.S35120 ◽  
Author(s):  
Feryal A. Ibrahim ◽  
Vignesh Shanmugam ◽  
Aliaa Amer ◽  
Halima El-Omri ◽  
Ahmad Al-Sabbagh ◽  
...  

Hepatosplenic T-cell lymphoma (HSTCL) is a rare and aggressive extranodal T-cell lymphoma that comprises <5% of peripheral T-cell lymphomas. The majority of cases harbor the γδT-cell receptor (TCR), but recently, a few cases have been shown to express the αß TCR. Comparison of these two subtypes (αβ and γδ) shows similar clinicopathologic and cytogenetic features; however, due to the paucity of reported cases, it is not clear whether they are prognostically distinct entities. We report a case of αβ HSTCL with a rather unusual presentation of Coombs'-negative hemolytic anemia. Diagnosis proved challenging due to an unusual blastoid morphology with the absence of typical intrasinusoidal distribution of tumor cells in the bone marrow. This unique case adds to the growing list of this rare subtype of T-cell lymphomas, which warrant urgent attention due to the lack of effective treatment options and dismal prognosis.

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Ana Caballero ◽  
Silvana Novelli ◽  
Anna Mozos ◽  
Pilar Garcia Muret ◽  
Anna Monter ◽  
...  

Within T-cell lymphomas (TCL) there are 2 entities expressing gamma-delta TCR: hepatosplenic gamma-delta T-cell lymphoma (HSGDTL) and the primary cutaneous gamma-delta T-cell lymphoma (PCGDTL). PCGDTL is a rare form of Tcell lymphoma with specific tropism for skin that have a dismal prognosis. Although even rarer, there have been reports of TCL with loss of expression of the TCR, which have been termed peripheral TCL TCR-silent type. We report the case of a cutaneous TCR-silent type lymphoma associated to a clonal plasma cell proliferation with an ominous outcome that led to a lot of discussion in its classification. Due to the aggressiveness of the disease and the scant evidence about therapy in this strange entity the outcome was fatal. We report a unique case of a TCR-silent cutaneous TCL with an exceptional histopathology, prolonged clinical evolution and a subsequent plasma cell clonal expansion.


2003 ◽  
Vol 127 (3) ◽  
pp. e119-e122
Author(s):  
Jingyu Dong ◽  
Yap-Yee Chong ◽  
Howard J. Meyerson

Abstract Hepatosplenic T-cell lymphoma is an uncommon neoplasm characterized by a lymphoid infiltrate within the sinusoids of the liver, spleen, and bone marrow, without significant nodal involvement. The majority of cases express the γδ T-cell receptor and are associated with an isochromosome 7q cytogenetic abnormality. Recently, a small number of cases have been reported that express the αβ T-cell receptor. Here, we report our findings of a case of an S100-positive hepatosplenic αβ T-cell lymphoma in a 20-year-old woman who presented with pancytopenia and hepatosplenomegaly. The case adds to the growing literature of hepatosplenic αβ T-cell lymphomas.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Laura Alder ◽  
Scott Graupner ◽  
Guanhua Lai ◽  
Victor Yazbeck

Hepatosplenic T-cell lymphomas (TCLs) are a rare, aggressive subset of TCLs, accounting for less than 5% of all peripheral T-cell and natural killer (NK) cell lymphomas. We report the case of a CD3 negative hepatosplenic T-cell lymphoma in a 42-year-old female, who presented with left-sided abdominal pain. She underwent a liver biopsy that showed marked abnormal sinusoidal lymphoid infiltration. PET scan revealed increased splenic and pharyngeal lymph node uptake. Immunophenotype was remarkable for negative CD3, gamma delta T-cell receptor, and alpha beta-T-cell receptor expression. She received 6 cycles of DA-EPOCH, had primary refractory disease and then underwent palliative splenectomy secondary to painful necrosis. Then, she was started on pralatrexate as a single agent and then in combination with romidepsin as a potential bridge to an allogeneic stem cell transplantation from her sibling.


2013 ◽  
Vol 31 (16) ◽  
pp. 1922-1927 ◽  
Author(s):  
Matthew A. Lunning ◽  
Alison J. Moskowitz ◽  
Steven Horwitz

A 69-year-old woman was referred for further evaluation and management of relapsed angioimmunoblastic T-cell lymphoma. At diagnosis, she received six cycles of dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) and achieved a complete response (CR). Her first surveillance computed tomography scan 3 months later demonstrated enlarging cervical lymphadenopathy. A lymph node excision confirmed relapsed angioimmunoblastic T-cell lymphoma with atypical lymphocytes expressing CD3, CD4, CD10, PD-1, and EBER, with loss of CD5 ( Fig 1 ). A clonal T-cell receptor beta and gamma rearrangement by polymerase chain reaction was identical to that in her initial diagnostic biopsy. At our initial consultation, options for standard as well as investigational therapies were discussed, and HLA typing was initiated. The patient was enrolled onto an investigational phase II study; however, she developed progressive disease after two cycles. She was then treated with romidepsin 14 mg/m2 administered intravenously for 3 consecutive weeks with 1 week off. After two cycles, she achieved a partial response, and after four additional cycles, she maintained her response without further improvement. We discussed additional treatment options.


2000 ◽  
Vol 24 (3) ◽  
pp. 459-463 ◽  
Author(s):  
Raymond Lai ◽  
Loree M. Larratt ◽  
Wai Etches ◽  
Shane T. Mortimer ◽  
Lawrence D. Jewell ◽  
...  

1991 ◽  
Vol 74 (4) ◽  
pp. 668-672 ◽  
Author(s):  
Martin M. Bednar ◽  
Anthony Salerni ◽  
Martin E. Flanagan ◽  
William W. Pendlebury

✓ Primary central nervous system (CNS) T-cell lymphoma is extremely rare. The present case report provides immunocytochemical evidence for a cerebellar CNS T-cell lymphoma. The patient underwent surgery followed by radiation therapy and is alive and well 36 months postoperatively. The clinical and pathological features of primary CNS T-cell lymphoma as well as diagnostic measures and treatment options are discussed, together with a compilation of all previous case reports of primary CNS T-cell lymphomas.


2019 ◽  
Vol 7 (1) ◽  
pp. 61-69
Author(s):  
Nikolaos F. Giannakoulas ◽  
Enrique Speletas

Hepatosplenic T-cell lymphoma (HSTCL) is a rare, aggressive T- cell lymphoma that is characterized by hepatosplenic and bone marrow sinusoidal infiltration of cytotoxic T cells, usually of gamma-delta (γδ) T-cell receptor type. The diagnosis was challenging as he required an extensive investigation that ultimately showed the characteristic clinical, histopathologic, and cytogenetic features of hepatosplenic T-cell lymphoma. We report a case of 12-year-old girl patient with HSTCL and visceral leishmaniasis, presented with progressive jaundice, massive hepatosplenomegaly, and weight loss. The diagnosis was required an extensive investigation that ultimately revealed the characteristically clinical, histopathological and cytogenetic features of hepatosplenic T-Cell Lymphoma. The clinical course was aggressive and multi-agent chemotherapy are used. The importance of considering it in a differential diagnosis of hepatosplenomegaly in young girl who present with constitutional symptoms and visceral leishmaniasis without lymphadenopathy.


mSphere ◽  
2019 ◽  
Vol 4 (4) ◽  
Author(s):  
Hani Nakhoul ◽  
Zhen Lin ◽  
Xia Wang ◽  
Claire Roberts ◽  
Yan Dong ◽  
...  

ABSTRACTCertain peripheral T-cell lymphomas (PTCLs) have been associated with viral infection, particularly infection with Epstein-Barr virus (EBV). However, a comprehensive virome analysis across PTCLs has not previously been reported. Here we utilized published whole-transcriptome RNA sequencing (RNA-seq) data sets from seven different PTCL studies and new RNA-seq data from our laboratory to screen for virus association, to analyze viral gene expression, and to assess B- and T-cell receptor diversity paradigms across PTCL subtypes. In addition to identifying EBV in angioimmunoblastic T-cell lymphoma (AITL) and extranodal NK/T-cell lymphoma (ENKTL), two PTCL subtypes with well-established EBV associations, we also detected EBV in several cases of anaplastic large-cell lymphoma (ALCL), and we found evidence of infection by the oncogenic viruses Kaposi’s sarcoma-associated herpesvirus and human T-cell leukemia virus type 1 in isolated PTCL cases. In AITLs, EBV gene expression analysis showed expression of immediate early, early, and late lytic genes, suggesting either low-level lytic gene expression or productive infection in a subset of EBV-infected B-lymphocyte stromal cells. Deconvolution of immune cell subpopulations demonstrated a greater B-cell signal in AITLs than in other PTCL subtypes, consistent with a larger role for B-cell support in the pathogenesis of AITL. Reconstructed T-cell receptor (TCR) and B-cell receptor (BCR) repertoires demonstrated increased BCR diversity in AITLs, consistent with a possible EBV-driven polyclonal response. These findings indicate potential alternative roles for EBV in PTCLs, in addition to the canonical oncogenic mechanisms associated with EBV latent infection. Our findings also suggest the involvement of other viruses in PTCL pathogenesis and demonstrate immunological alterations associated with these cancers.IMPORTANCEIn this study, we utilized next-generation sequencing data from 7 different studies of peripheral T-cell lymphoma (PTCL) patient samples to globally assess viral associations, provide insights into the contributions of EBV gene expression to the tumor phenotype, and assess the unique roles of EBV in modulating the immune cell tumor microenvironment. These studies revealed potential roles for EBV replication genes in some PTCL subtypes, the possible role of additional human tumor viruses in rare cases of PTCLs, and a role for EBV in providing a unique immune microenvironmental niche in one subtype of PTCLs. Together, these studies provide new insights into the understudied role of tumor viruses in PTCLs.


Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 545-549 ◽  
Author(s):  
Neha Mehta–Shah ◽  
Steven Horwitz

Abstract Although all the peripheral T-cell lymphomas are uncommon, there are some entities that are truly rare. Subtypes, such as enteropathy-associated T-cell lymphoma, hepatosplenic T-cell lymphoma, extranodal NK/T-cell lymphoma, and subcutaneous panniculitis-like T-cell lymphoma, have an approximate annual incidence in United States of <500 each. In these very rare subtypes, there is limited data to guide clinical decision-making. As such, our treatment decisions are often based on extrapolation, case series, personal experience, and biases. We summarize the existing data regarding initial management of these entities and compare how that management follows paradigms established for the more common T-cell lymphomas.


2002 ◽  
Vol 69 (4) ◽  
pp. 272-276 ◽  
Author(s):  
G. Motta ◽  
F. Vianello ◽  
C. Menin ◽  
A. De Nicolo ◽  
S. Agata ◽  
...  

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