Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2010 Feb;25(2):309-12. doi: 10.3346/jkms.2010.25.2.309. Epub 2010 Jan 19.
Indolent T-lymphoblastic proliferation has been rarely reported in the upper aerodigestive tract. The lymphoid cells associated with this condition have the morphological and phenotypical features of immature thymocytes. However, their pathogenesis and biology are unknown. We present an unusual type of tumor infiltrating lymphocytes in a case with hepatocellular carcinoma, presumed to be a T-lymphoblastic proliferation. A 58-yr-old female patient presented with indigestion and a palpable epigastric mass. The abdominal computed tomography revealed a mass in the S6 region of the liver. A hepatic segmentectomy was performed. Microscopic examination showed dense isolated nests of monomorphic lymphoid cells within the tumor. Immunohistochemically, the lymphoid cells were positive for CD3, terminal deoxymucleotide transferase (TdT) and CD1a. In addition, they showed dual expression of CD4 and CD8. The polymerase chain reaction used to examine the T-cell antigen receptor gamma gene rearrangement showed polyclonal T-cell proliferation. This is the second case of hepatocellular carcinoma combined with indolent T-lymphoblastic proliferation identified by an unusual tumor infiltrating lymphocytes.
惰性 T 淋巴母细胞性增殖在上呼吸道消化道中很少见。与这种情况相关的淋巴细胞具有不成熟的胸腺细胞的形态和表型特征。然而，它们的发病机制和生物学特性尚不清楚。我们报告了一例肝癌中浸润性淋巴细胞的不典型类型，推测为 T 淋巴母细胞性增殖。一位 58 岁女性患者因消化不良和可触及的上腹部肿块就诊。腹部计算机断层扫描显示肝脏 S6 区有一个肿块。进行了肝段切除术。显微镜检查显示肿瘤内有密集的单一形态淋巴样细胞巢。免疫组织化学染色显示，淋巴细胞对 CD3、末端脱氧核苷酸转移酶 (TdT) 和 CD1a 呈阳性。此外，它们还表现出 CD4 和 CD8 的双重表达。用于检测 T 细胞抗原受体γ基因重排的聚合酶链反应显示多克隆 T 细胞增殖。这是通过不典型肿瘤浸润淋巴细胞鉴定的第二例肝癌合并惰性 T 淋巴母细胞性增殖。
