Lennert's lymphoma: Clinicopathological profile of five cases.

Background and Aim: Lennert’s lymphoma is a rare variant of peripheral T-cell lymphoma (PTCL) not otherwise specifi ed (NOS) rich in epithelioid histiocytes. This study aims to analyze the clinical, morphologic, and immunophenotypic profi le of cases of Lennert’s lymphoma from our country and determines the utility of T-cell receptor (TCR) gene rearrangement in the diagnosis. Materials and Methods: All cases diagnosed as Lennert’s lymphoma during the period of January 2001 to August 2011 were included in this study. Hematoxylin and eosin (H and E) stained slides and immunohistochemistry results were analyzed and TCR gene rearrangement was performed. Results: There were fi ve cases of Lennert’s lymphoma diagnosed in our institution during this period, which included two males and three females. All cases showed effacement of lymph node architecture by diffuse infi ltration of small lymphoid T cells [CD3+, CD4+, CD8+, T-cell intracellular antigen 1 (TIA-1+), Granzyme B−] and clusters of epithelioid histiocytes throughout the lymph node and scattered large transformed cells (CD20−, CD30+, CD15−/+). TCR rearrangement was done in three cases by polymerase chain reaction (PCR) and showed the presence of a clonal T-cell population. Conclusions: Lennert’s lymphoma constituted 0.11% of all non-Hodgkin lymphomas (NHLs) in our institution. Differentiation from classical Hodgkin’s lymphoma is sometimes diffi cult by morphology and immunohistochemistry alone and TCR gene rearrangement was extremely useful in diagnosis.

A Case of Hepatosplenic T-cell Lymphoma Diagnosed by Bone Marrow Examination

Hepatosplenic T-cell lymphoma (HSTL) is a condition in which lymphoma cells infiltrate the sinusoids of the liver, spleen, and bone marrow, without lymph node involvement. We encountered a case of hepatosplenic T-cell lymphoma in a Vietnamese woman. The patient was hospitalized with epigastric pain and nausea. Splenomegaly and multiple poorly defined, low-attenuating nodular lesions in the liver were visualized on computed tomography (CT), and thrombocytopenia was noted. The lymph nodes were not significantly enlarged. Splenic biopsy could not be performed because of severe thrombocytopenia. Neoplastic lymphoid cells were present in bone marrow aspirates. Bone marrow sections revealed infiltration of CD3(+) and CD20(-) neoplastic lymphoid cells in the sinusoids. A clonality assay (IdentiClone T-Cell Receptor Delta Gene Clonality Assay; Invivoscribe Technologies, USA) showed gene rearrangements in the T-cell receptor delta gene. Thus, we made a confirmatory diagnosis of HSTL. When splenic biopsy is not available, bone marrow aspirates and clonality assessment may become useful diagnostic tools.

A Case of CD7+, CD4-, CD8-, CD3-acute T cell lymphoblastic leukemia / 대한임상병리학회지

A CD7 positive acute leukemia, lacking CD4, CD8, CD3, CD13 and CD33 expression may include 4 categories; acute T-cell leukemia, mixed lineage leukemia, acute undifferentiated leukemia and CD7 positive acute myeloid leukemia. Therefore, the expression of cyCD3 or the presence of TCR gene rearrangement can make the diagnosis of acute T-cell leukemia. We report a patient with acute T-cell lymphoblastic leukemia, showing CD7+, CD4-CD8-, and CD3-expression and TCR gamma gene rearrangement.

Alteration of configuration of immunoglobulin and T cell receptor genes in early stage of children acute leukemia / 中国免疫学杂志

Phenotypic markers of leukemic cells from 29 children with acute leukemia were examined. Of these cases, six were negative for myeloperoxidase and did not react with lineage-associated or mature lineage-associated monoclonal antibodies. Then, we analyzed the configuration of both immunoglobulin (heavy chain and kappa chain) and T-cell receptor (?, ?, ?) genes in these six cases. All cases had rearrangement of IgH were suggestive of B-lymphoid origin of these leukemic cells. Two cases without CD10 antigen had no rearrangement of kappa chain, one with retention of the germline configuration of TCR ?, ?. ?, the other with retention of the germline of TCR ? gene. In the cases with CD10 antigen, two cases showed kappa chain deletion, the alteration of TCR genes (rearrangements or deletions )was shown to occur frequently. These findings may implicate that the gene rearrange ments forming functional IgH gene in leukemic cells with CD10 antigen, induce the alteration of IgL and TCR genes.