Li D J, Kang H, Zhang L, Xu Z G, Wang X Y, Wang L F, Song X X, Kong L F
Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
Zhonghua Bing Li Xue Za Zhi. 2022 May 8;51(5):413-418. doi: 10.3760/cma.j.cn112151-20211219-00913.
To investigate the clinicopathological characteristics and prognosis of mature T/NK cell lymphomas with aberrant CD20 or CD79α expression. A retrospective analysis of 641 cases of mature T/NK cell lymphoma diagnosed from January 2014 to December 2020 was performed, and 14 cases of CD20-positive and one case of CD79α-positive mature T/NK-cell lymphoma were identified. Histological examination, immunohistochemical characterization, in situ hybridization for Epstein-Barr virus encoded early RNA (EBER), and PCR testing for immunoglobulin and T cell receptor (TCR) gene rearrangements were performed. Clinicopathological characteristics of these lymphomas were analyzed. There were 13 males and 2 females, with a median age of 56 years. There were 8 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), 3 cases of extranodal NK/T-cell lymphoma, nasal type (ENKTCL), 2 cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) and 2 cases of angioimmunoblastic T-cell lymphoma (AITL). Twelve cases were stage Ⅲ or Ⅳ lymphomas. The prognosis was overall poor. The histology, immunophenotype and TCR gene rearrangement were not significantly different from the corresponding types of lymphoma. Ki-67 proliferation index was over 70% in all cases. The expression of CD20 or CD79α was weak and heterogeneous. All 15 case of Ig gene rearrangement were polyclonal. Mature T/NK cell lymphoma with abnormal expression of CD20 or CD79α is rare, commonly found in advanced stage, and associated with poor prognosis. The expression of CD20 or CD79α in these cases is weaker than the corresponding mature T/NK cell lymphomas, while its proliferation index is higher. Histomorphology, extensive immunoprofiling and molecular detection are required for accurate diagnosis.
探讨伴有异常CD20或CD79α表达的成熟T/NK细胞淋巴瘤的临床病理特征及预后。对2014年1月至2020年12月诊断的641例成熟T/NK细胞淋巴瘤进行回顾性分析,共鉴定出14例CD20阳性和1例CD79α阳性的成熟T/NK细胞淋巴瘤。进行了组织学检查、免疫组化特征分析、爱泼斯坦-巴尔病毒编码早期RNA(EBER)原位杂交以及免疫球蛋白和T细胞受体(TCR)基因重排的PCR检测。分析了这些淋巴瘤的临床病理特征。患者共13例男性和2例女性,中位年龄56岁。其中8例为外周T细胞淋巴瘤,非特指型(PTCL-NOS),3例为结外NK/T细胞淋巴瘤,鼻型(ENKTCL),2例为单形性亲上皮性肠T细胞淋巴瘤(MEITL),2例为血管免疫母细胞性T细胞淋巴瘤(AITL)。12例为Ⅲ或Ⅳ期淋巴瘤。总体预后较差。其组织学、免疫表型和TCR基因重排与相应类型的淋巴瘤无明显差异。所有病例的Ki-67增殖指数均超过70%。CD20或CD79α的表达较弱且不均一。15例Ig基因重排均为多克隆性。伴有CD20或CD79α异常表达的成熟T/NK细胞淋巴瘤罕见,常见于晚期,预后较差。这些病例中CD20或CD79α的表达比相应的成熟T/NK细胞淋巴瘤弱,而其增殖指数较高。准确诊断需要组织形态学检查、广泛的免疫表型分析和分子检测。