Department of Pathology, L235, Stanford University School of Medicine, Stanford, CA 94305-5324, USA.
Hum Pathol. 2013 Apr;44(4):451-71. doi: 10.1016/j.humpath.2012.02.007. Epub 2012 May 30.
T-cell lymphomas represent a heterogeneous group of neoplasms that encompass considerable clinical, morphologic, and immunophenotypic variation. The diagnosis of T-cell lymphoma is challenging because of its relative rarity, the lack of an immunophenotypic marker of clonality, and significant morphologic overlap with infectious/inflammatory processes and neoplasms, including Hodgkin and other non-Hodgkin lymphomas, and even mesenchymal or epithelial lesions. In the current World Health Organization classification of hematopoietic tumors, all except 1 subtype (ie, T-lymphoblastic lymphoma) are recognized as mature neoplasms derived from postthymic T cells. In addition to T-lymphoblastic lymphoma, this review will focus on nodal and extranodal T-cell lymphomas and exclude T-cell lymphomas presenting primarily in the skin. Extranodal natural-killer-cell/T-cell lymphoma, nasal type, will also be discussed because the derivation of this lymphoma from natural killer and natural killer-like T cells shows morphologic and immunophenotypic features that overlap with other T-cell lymphomas. In this review, we discuss the salient clinicopathologic, immunophenotypic, and genetic features, as well as our approaches to the diagnosis of lymphoblastic, nodal, and extranodal T-cell lymphomas.
T 细胞淋巴瘤是一组异质性肿瘤，具有相当大的临床、形态和免疫表型变异。由于其相对罕见、缺乏克隆性免疫表型标志物以及与感染/炎症过程和肿瘤（包括霍奇金和其他非霍奇金淋巴瘤，甚至间叶或上皮病变）的显著形态重叠，T 细胞淋巴瘤的诊断具有挑战性。在目前的造血肿瘤世界卫生组织分类中，除 1 个亚型（即 T 淋巴母细胞淋巴瘤）外，所有亚型均被认为是源自胸腺后 T 细胞的成熟肿瘤。除 T 淋巴母细胞淋巴瘤外，本综述还将重点关注结内和结外 T 细胞淋巴瘤，并排除主要发生在皮肤的 T 细胞淋巴瘤。此外，还将讨论结外自然杀伤细胞/T 细胞淋巴瘤，鼻型，因为这种淋巴瘤来源于自然杀伤细胞和自然杀伤样 T 细胞，其形态和免疫表型特征与其他 T 细胞淋巴瘤重叠。在本综述中，我们讨论了淋母细胞性、结内和结外 T 细胞淋巴瘤的显著临床病理、免疫表型和遗传特征，以及我们对这些淋巴瘤的诊断方法。
