Jones D, Weissmann D J, Kraus M D, Hasserjian R P, Shahsafaei A, Dorfman D M
Department of Pathology, at UT-M.D. Anderson Cancer Center, Houston, USA.
Am J Clin Pathol. 2000 Sep;114(3):438-47. doi: 10.1093/ajcp/114.3.438.
We examined the patterns of relapse or persistence in 37 cases of nodal peripheral T-cell lymphoma (PTCL) to address the morphologic and immunophenotypic findings. Relapses were documented in lymph node (25 cases) and/or a variety of extranodal sites at a mean of 21 months after presentation; several cases recurred as late as 13 years. Persistent bone marrow involvement was a feature of angioimmunoblastic lymphoma (AIL) and histiocyte-rich and small-cell tumors. Relapses in anaplastic tumors often involved unusual extranodal sites. The majority of relapsed PTCLs retained a similar histologic appearance, pattern of nodal involvement, and immunophenotype. Histologic progression, as assessed by increased numbers of large cells, was seen in 3 cases of AIL, in 1 case with an initial small cell morphologic appearance, and in 2 cases of PTCL with an initial mixed small and large cell appearance. Immunostains for T-cell activation markers showed increased immunoreactive cells in 5 of the 6 cases, whereas increased numbers of p53-positive tumor cells were noted in 3 of the 6 cases. The discrete large cell transformation occasionally seen in B-cell lymphoma and extranodal T-cell lymphoma was not observed in these cases.
我们研究了37例淋巴结外周T细胞淋巴瘤（PTCL）的复发或持续模式，以探讨其形态学和免疫表型特征。复发记录于淋巴结（25例）和/或多种结外部位，平均出现在初诊后21个月；有几例复发时间晚至13年。持续性骨髓受累是血管免疫母细胞性淋巴瘤（AIL）以及富含组织细胞和小细胞肿瘤的特征。间变性肿瘤的复发常累及不寻常的结外部位。大多数复发的PTCLs保留了相似的组织学表现、淋巴结受累模式和免疫表型。在3例AIL、1例最初表现为小细胞形态的病例以及2例最初表现为小细胞和大细胞混合形态的PTCL病例中，可见组织学进展，表现为大细胞数量增加。T细胞活化标志物免疫染色显示6例中有5例免疫反应性细胞增多，而6例中有3例p53阳性肿瘤细胞数量增加。在这些病例中未观察到B细胞淋巴瘤和结外T细胞淋巴瘤中偶尔出现的离散性大细胞转化。
