First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Pathol Int. 2011 May;61(5):326-30. doi: 10.1111/j.1440-1827.2011.02656.x. Epub 2011 Mar 30.
Peripheral T-cell lymphoma (PTCL) with a follicular growth pattern is very rare. Herein, a case of follicular variant of PTCL in a 50-year-old man who complained of tonsillar and generalized lymph node swelling is reported. The resected tonsil revealed a vague nodular growth pattern of atypical cells, medium to large in size, with abundant pale cytoplasm. The lymphoma cells were CD3(+) CD4(+) CD5(+) CD8(-) CD10(+) CD56(-) CD57(-) BCL6(+) PD-1(+) CXCL13(+) and were associated with a meshwork of CD21(+) follicular dendritic cells. Molecular studies revealed clonal rearrangement of the T-cell receptor gamma chain gene but not of the immunoglobulin gene. Cytogenetic analysis disclosed a complex abnormality in 18 of 20 cells with the exclusion of t(5; 9). These findings suggest that the present case is a follicular variant of PTCL derived from follicular T-helper cells.
外周 T 细胞淋巴瘤(PTCL)伴滤泡生长模式非常罕见。本文报告了一例 50 岁男性患者,因扁桃体和全身淋巴结肿大就诊,诊断为滤泡型 PTCL。切除的扁桃体显示出不典型细胞的模糊结节状生长模式,大小中等,细胞质丰富淡染。淋巴瘤细胞 CD3(+) CD4(+) CD5(+) CD8(-) CD10(+) CD56(-) CD57(-) BCL6(+) PD-1(+) CXCL13(+),并伴有 CD21(+)滤泡树突状细胞网。分子研究显示 T 细胞受体γ链基因呈克隆性重排,但免疫球蛋白基因无重排。细胞遗传学分析显示 20 个细胞中有 18 个存在复杂异常,排除 t(5; 9)。这些发现提示本例为来源于滤泡辅助性 T 细胞的滤泡型 PTCL。