Department of Medicine, Division of Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Department of Medicine, Division of Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Clin Lymphoma Myeloma Leuk. 2023 Sep;23(9):642-650. doi: 10.1016/j.clml.2023.05.012. Epub 2023 May 23.
Mature T- and NK-cell neoplasms (MTNKN) collectively represent a rare disorder, representing less than 15% of all non-Hodgkin lymphoma (NHL) cases and qualifying for orphan disease designation by the U.S. Food and Drug Administration (FDA). These consist of 9 families in the fifth revised WHO classification of lymphoid neoplasms, which are made up of over 30 disease subtypes, underscoring the heterogeneity of clinical features, molecular biology, and genetics across this disease group. Moreover, the 5 most common subtypes (peripheral T-cell lymphoma, not otherwise specified; nodal TFH cell lymphoma, angioimmunoblastic type; extranodal NK-cell/T-cell lymphoma; adult T-cell leukemia/lymphoma; and ALK-positive or -negative anaplastic large cell lymphoma) comprise over 75% of MTNKN cases, so other subtypes are exceedingly rare in the context of all NHL diagnoses and consequently often lack consensus on best practices in diagnosis and management. In this review, we discuss the following entities-enteropathy-associated T-cell lymphoma (EATL), monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), hepatosplenic T-cell lymphoma (HSTCL), subcutaneous panniculitis-like T-cell lymphoma (SPTCL), and primary cutaneous ɣδ T-cell lymphoma (PCGD-TCL) - with an emphasis on clinical and diagnostic features and options for management.
成熟 T 细胞和 NK 细胞肿瘤(MTNKN)共同代表了一种罕见的疾病,占所有非霍奇金淋巴瘤(NHL)病例的比例不到 15%,并符合美国食品和药物管理局(FDA)的孤儿病指定标准。这些肿瘤在第五版修订的 WHO 淋巴肿瘤分类中属于 9 个家族,由超过 30 种疾病亚型组成,这突出了该疾病组在临床特征、分子生物学和遗传学方面的异质性。此外,最常见的 5 个亚型(外周 T 细胞淋巴瘤,非特指型;结内滤泡辅助性 T 细胞淋巴瘤,血管免疫母细胞性型;结外 NK/T 细胞淋巴瘤;成人 T 细胞白血病/淋巴瘤;以及 ALK 阳性或阴性间变性大细胞淋巴瘤)占 MTNKN 病例的 75%以上,因此其他亚型在所有 NHL 诊断中极为罕见,因此在诊断和管理方面往往缺乏共识。在这篇综述中,我们讨论了以下实体-肠病相关 T 细胞淋巴瘤(EATL)、单形上皮亲嗜性肠 T 细胞淋巴瘤(MEITL)、肝脾 T 细胞淋巴瘤(HSTCL)、皮下脂膜炎样 T 细胞淋巴瘤(SPTCL)和原发性皮肤 γδ T 细胞淋巴瘤(PCGD-TCL)-重点讨论了临床和诊断特征以及管理选择。