Tan Brenton T, Warnke Roger A, Arber Daniel A
Department of Pathology, Stanford University School of Medicine, 300 Pasteur Dr., Room L235, Stanford, CA 94305-5324, USA.
J Mol Diagn. 2006 Sep;8(4):466-75; quiz 527. doi: 10.2353/jmoldx.2006.060016.
We report on a series of 58 cases of angioimmunoblastic T-cell lymphoma (AILT) and 59 cases of peripheral T-cell lymphoma, unspecified (PTCL-NOS). Subsets of cases from both diagnostic groups were complicated by associated B-cell proliferations, and we performed B- and T-cell clonality studies and in situ hybridization for Epstein-Barr virus (EBV) to investigate the relationship between B-cell proliferation, B-cell clonality, and EBV. Using multiplex polymerase chain reaction assays based on the BIOMED-2 collaborative study, we detected TCRgamma T-cell clones in 78 and 81% of AILT and PTCL-NOS cases, respectively, and IGH B-cell clones in 34 and 35% of AILT and PTCL-NOS cases, respectively. The majority of cases contained EBV-positive cells, including 50% of AILT and 57% of PTCL-NOS cases, and cases with B-cell proliferations were more often EBV-positive. Although a relatively high rate of B-cell clonality has been shown for AILT, our findings for PTCL-NOS differ from previous reports in that B-cell clonality was relatively frequent. Overall, a positive B-cell clone correlated, in part, with the presence of a B-cell proliferation but not with EBV. Our findings demonstrate that B-cell clonality is a common finding in AILT and PTCL-NOS, and its presence should not negate the diagnosis established by morphologic, immunophenotypic, and clinical findings.
我们报告了一系列58例血管免疫母细胞性T细胞淋巴瘤(AILT)和59例未特指的外周T细胞淋巴瘤(PTCL-NOS)。两个诊断组中的部分病例合并有相关的B细胞增殖,我们进行了B细胞和T细胞克隆性研究以及爱泼斯坦-巴尔病毒(EBV)原位杂交,以研究B细胞增殖、B细胞克隆性和EBV之间的关系。基于BIOMED-2合作研究采用多重聚合酶链反应分析,我们分别在78%的AILT病例和81%的PTCL-NOS病例中检测到TCRγ T细胞克隆,分别在34%的AILT病例和35%的PTCL-NOS病例中检测到IGH B细胞克隆。大多数病例含有EBV阳性细胞,包括50%的AILT病例和57%的PTCL-NOS病例,且伴有B细胞增殖的病例更常为EBV阳性。尽管已显示AILT的B细胞克隆性发生率相对较高,但我们关于PTCL-NOS的研究结果与既往报道不同,即B细胞克隆性相对常见。总体而言,B细胞克隆阳性部分与B细胞增殖的存在相关,但与EBV无关。我们的研究结果表明,B细胞克隆性在AILT和PTCL-NOS中是常见发现,其存在不应否定由形态学、免疫表型和临床发现所确立的诊断。