In:
American Journal of Surgical Pathology, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 6 ( 2016-06), p. 777-785
Abstract:
The differential diagnosis of primary gastrointestinal EBV − T-cell lymphoma (GITCL) includes enteropathy-associated T-cell lymphoma (EATL), peripheral T-cell lymphoma, not otherwise specified, adult T-cell leukemia/lymphoma, and anaplastic large cell lymphoma. Type II EATL is considered to be a tumor of intraepithelial lymphocytes. However, the evaluation of intraepithelial lymphocytosis by biopsy specimens is challenging, which poses a diagnostic problem between the EATL and peripheral T-cell lymphoma, not otherwise specified. This situation requested us to establish a pragmatic diagnostic approach for the classification of GITCL. We identified 42 cases of GITCL and analyzed clinicopathologic features, especially addressing their T-cell receptor (TCR) phenotype. Nine (21%) of 42 GITCL cases were positive for TCRγ protein expression. Among these TCRγ + cases, TCRβ expression or not was detected in 5 and 4, respectively, but resulted in no further clinicopathologic differences. TCRβ positivity without TCRγ expression (β + γ − ) was seen in 9 GITCL patients (21%). Twenty-four patients (57%) were negative for TCRβ and γ expression (β − γ − ). Compared with TCRβ + γ − or β − γ − type, TCRγ + cases were characterized by exclusive involvement of intestinal sites (100% vs. 11%, P 〈 0.001; 100% vs. 58%, P =0.032, respectively), but not of stomach (0% vs. 78%, P =0.002; 0% vs. 38%, P =0.039, respectively). Notably, TCRγ positivity was an independent unfavorable prognostic factor among our GITCL patients ( P 〈 0.001). Considering our results, TCRγ + GITCL, that is, intestinal γδ T-cell lymphoma, appears to constitute a distinct disease entity.
Type of Medium:
Online Resource
ISSN:
0147-5185
DOI:
10.1097/PAS.0000000000000630
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2016
detail.hit.zdb_id:
2029143-7
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