惰性 T 细胞/自然杀伤细胞淋巴瘤/胃肠道淋巴组织增生性疾病-在过去十年中我们学到了什么?
Indolent T-Cell/Natural Killer-Cell Lymphomas/Lymphoproliferative Disorders of the Gastrointestinal Tract-What Have We Learned in the Last Decade?
机构信息
Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, the People's Republic of China.
Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, the People's Republic of China.
出版信息
Lab Invest. 2024 Apr;104(4):102028. doi: 10.1016/j.labinv.2024.102028. Epub 2024 Feb 19.
Primary gastrointestinal (GI) T-cell and natural killer (NK)-cell lymphomas/lymphoproliferative disorders (LPD) are uncommon, and they are usually aggressive in nature. However, T-cell and NK-cell lymphoma/LPD of the GI tract with indolent clinical course has been reported over the past 2 decades. Indolent T-cell LPD was formally proposed a decade ago in 2013 and 4 years later recognized as a provisional entity by the revised fourth edition of WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues in 2017. Indolent T-cell LPD of the GI tract has been changed to indolent T-cell lymphoma of the GI tract as a distinct entity by the fifth edition of WHO Classification of Haematolymphoid Tumours, but the International Consensus Classification of mature lymphoid neoplasms prefers indolent clonal T-cell LPD of the GI tract instead. In the past decade, indolent lymphoma/LPD of the GI tract has been expanded to NK cells, and as such, indolent NK-cell LPD of the GI tract was recognized as an entity by both the fifth edition of WHO Classification of Haematolymphoid Tumours and the International Consensus Classification. The underlying genetic/molecular mechanisms of both indolent T-cell lymphoma/LPD of the GI tract and indolent NK-cell LPD of the GI tract have been recently discovered. In this review, we describe the history; salient clinical, cytohistomorphologic, and immunohistochemical features; and genetic/genomic landscape of both entities. In addition, we also summarize the mimics and differential diagnosis. Finally, we propose future directions with regard to the pathogenesis and clinical management.
原发性胃肠道(GI)T 细胞和自然杀伤(NK)-细胞淋巴瘤/淋巴增生性疾病(LPD)较为少见,且通常具有侵袭性。然而,过去 20 年来已有报道称,GI 道惰性 T 细胞淋巴瘤/LPD 具有惰性临床病程。10 年前(即 2013 年)首次正式提出惰性 T 细胞 LPD,4 年后,2017 年修订的第四版《WHO 造血和淋巴组织肿瘤分类》将其确认为一个临时实体。第五版《WHO 造血淋巴肿瘤分类》将 GI 道惰性 T 细胞 LPD 更改为 GI 道惰性 T 细胞淋巴瘤,作为一个明确的实体,但国际成熟淋巴肿瘤共识分类更倾向于 GI 道惰性克隆性 T 细胞 LPD。在过去的十年中,GI 道惰性淋巴瘤/LPD 已扩展到 NK 细胞,因此,GI 道惰性 NK 细胞 LPD 已被第五版《WHO 造血淋巴肿瘤分类》和国际成熟淋巴肿瘤共识分类确认为一个实体。最近发现了 GI 道惰性 T 细胞淋巴瘤/LPD 和 GI 道惰性 NK 细胞 LPD 的潜在遗传/分子机制。在这篇综述中,我们描述了这两个实体的历史、显著的临床、细胞形态学和免疫组织化学特征以及遗传/基因组特征。此外,我们还总结了其模仿和鉴别诊断。最后,我们提出了发病机制和临床管理方面的未来研究方向。