Tachibana Takayoshi, Tomita Naoto, Furuya Mitsuko, Yamanaka Shoji, Takeuchi Kengo, Nakamura Naoya, Fujita Hiroyuki, Ishigatsubo Yoshiaki
Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Japan.
Intern Med. 2011;50(5):495-9. doi: 10.2169/internalmedicine.50.4386. Epub 2011 Mar 1.
We report on a 60-year-old man, having angioimmunoblastic T-cell lymphoma (AITL) with aberrant expression of CD20. The initial biopsy specimen showed features of AITL with the typical CD3(+)CD20(-) immunophenotype. As the disease progressed, biopsy specimens of the recurrent lesions showed unusual results for AITL with the CD20(+) immunophenotype in both flow cytometry and immunohistochemistry analysis. Double immunostaining confirmed that the lymphoma cells were simultaneously positive for CD3 and CD20. The disease became resistant to combined chemotherapies and the patient died 3 years after the initial diagnosis. Autopsy revealed a composite of AITL and EBV-positive diffuse large B-cell lymphoma. Although it is unknown whether the instability of the CD20 antigen expression is correlated with the behaviour of AITL, the administration of rituximab should be considered as an alternative therapeutic option in such cases.
我们报告了一名60岁男性，患有血管免疫母细胞性T细胞淋巴瘤（AITL）且CD20表达异常。最初的活检标本显示为具有典型CD3(+)CD20(-)免疫表型的AITL特征。随着疾病进展，复发病变的活检标本在流式细胞术和免疫组织化学分析中均显示出具有CD20(+)免疫表型的不寻常的AITL结果。双重免疫染色证实淋巴瘤细胞同时CD3和CD20呈阳性。该疾病对联合化疗产生耐药，患者在初次诊断后3年死亡。尸检显示为AITL与EBV阳性弥漫性大B细胞淋巴瘤的复合情况。尽管尚不清楚CD20抗原表达的不稳定性是否与AITL的行为相关，但在这种情况下应考虑使用利妥昔单抗作为替代治疗选择。
