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鼻型结外T/NK细胞淋巴瘤:6例临床病理研究

Nodal T/NK-cell lymphoma of nasal type: a clinicopathological study of six cases.

作者信息

Takahashi E, Asano N, Li C, Tanaka T, Shimada K, Shimada S, Yoshino T, Kojima M, Hara K, Eimoto T, Nakamura S

机构信息

Department of Pathology, Aichi Medical University Hospital, Nagakute, Japan.

出版信息

Histopathology. 2008 Apr;52(5):585-96. doi: 10.1111/j.1365-2559.2008.02997.x.

Abstract

AIMS

To investigate the clinicopathological features of six unusual cases of nodal CD56+ and Epstein-Barr virus (EBV)+ T/natural killer (NK)-cell lymphoma, a putative nodal counterpart of nasal NK/T-cell lymphoma (nodal T/NK-cell lymphoma of nasal type) in comparison with nasal NK/T-cell lymphoma with secondary lymph node involvement (n = 24) and peripheral T-cell lymphoma (PTCL) of cytotoxic molecule (CTM)+ and EBV+ type (n = 21).

METHODS AND RESULTS

All cases of nodal T/NK-cell lymphoma of nasal type exhibited diffuse infiltration of pleomorphic medium-sized to large tumour cells, reminiscent of those in CTM+ EBV+ PTCL. The tumour cells had a typical phenotype of nasal NK/T-cell lymphoma: CD2+, CD3epsilon+, CD4-, CD5-, CD56+, T-cell intracellular antigen-1+, granzyme B+, perforin+ and EBV+. However, four of six cases demonstrated clonal T-cell receptor gamma-gene rearrangement on polymerase chain reaction analysis, unlike nasal NK/T-cell lymphoma. Comparison of clinical parameters and overall survival among the three groups demonstrated only minor differences.

CONCLUSIONS

Nodal T/NK-cell lymphoma may occupy the grey zone between extranodal nasal-type NK/T-cell lymphoma and nodal CTM+ PTCL in a spectrum of NK to T-cell lymphomas that are EBV+. The close relationship between NK/T-cell lymphomas and cytotoxic T-cell lymphomas was also substantiated.

摘要

目的

研究6例不典型的淋巴结CD56阳性及爱泼斯坦-巴尔病毒(EBV)阳性T/自然杀伤(NK)细胞淋巴瘤的临床病理特征,其被认为是鼻NK/T细胞淋巴瘤(鼻型淋巴结T/NK细胞淋巴瘤)的淋巴结对应物,并与继发淋巴结受累的鼻NK/T细胞淋巴瘤(n = 24)以及细胞毒性分子(CTM)阳性及EBV阳性型外周T细胞淋巴瘤(PTCL,n = 21)进行比较。

方法与结果

所有鼻型淋巴结T/NK细胞淋巴瘤病例均表现为多形性中等大小至大的肿瘤细胞弥漫浸润,类似于CTM阳性EBV阳性PTCL中的肿瘤细胞。肿瘤细胞具有鼻NK/T细胞淋巴瘤的典型表型:CD2阳性、CD3ε阳性、CD4阴性、CD5阴性、CD56阳性、T细胞胞内抗原-1阳性、颗粒酶B阳性、穿孔素阳性及EBV阳性。然而,6例病例中有4例在聚合酶链反应分析中显示克隆性T细胞受体γ基因重排,这与鼻NK/T细胞淋巴瘤不同。三组之间临床参数及总生存的比较仅显示出微小差异。

结论

在EBV阳性的一系列NK到T细胞淋巴瘤中,淋巴结T/NK细胞淋巴瘤可能处于结外鼻型NK/T细胞淋巴瘤和淋巴结CTM阳性PTCL之间的灰色地带。NK/T细胞淋巴瘤与细胞毒性T细胞淋巴瘤之间的密切关系也得到了证实。

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