Zhang Fen, Li Wenyu, Cui Qian, Chen Yu, Liu Yanhui
Department of Pathology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Oncol. 2022 Oct 24;12:983585. doi: 10.3389/fonc.2022.983585. eCollection 2022.
Angioimmunoblastic T-cell lymphoma (AITL) is a common type of nodal peripheral T-cell lymphoma, which always presents with extensive follicular dendritic cell (FDC) meshwork. Here, we report a case of AITL combined with extensive spindle cell meshwork. Spindle cells occupied were positive for the FDC markers CD21, CD23, and CD35. Furthermore, some cells were positive for desmin and smooth muscle actin (SMA), suggesting the differentiation of fibroblastic reticular cell (FRC). Interestingly, the proliferation of spindle cells was so extensive that was easily misdiagnosed as FDC sarcoma (FDCS). Next-generation sequencing showed that the common mutations reported in AITL, including , , and , were also detected in this case, while the genes that are recurrently mutated in FDCS were not detected. Regrettably, the patient died 19 months later. Overall, we highlight the unusual morphologic features in an AITL patient with extensive FDC and FRC network that may be misdiagnosed as FDCS, and careful morphological observation and immunochemical and molecular examinations are crucial for an accurate diagnosis.
血管免疫母细胞性T细胞淋巴瘤（AITL）是一种常见的淋巴结外周T细胞淋巴瘤，常伴有广泛的滤泡树突状细胞（FDC）网络。在此，我们报告一例合并广泛梭形细胞网络的AITL病例。占据的梭形细胞FDC标志物CD21、CD23和CD35呈阳性。此外，一些细胞结蛋白和平滑肌肌动蛋白（SMA）呈阳性，提示成纤维网状细胞（FRC）分化。有趣的是，梭形细胞增殖广泛，容易误诊为FDC肉瘤（FDCS）。二代测序显示，该病例也检测到了AITL中报道的常见突变，包括 、 和 ，而未检测到FDCS中反复突变的基因。遗憾的是，患者19个月后死亡。总体而言，我们强调了一名具有广泛FDC和FRC网络的AITL患者的不寻常形态学特征，这些特征可能被误诊为FDCS，仔细的形态学观察、免疫化学和分子检查对于准确诊断至关重要。
