Clinicopathology, immunophenotype, T cell receptor gene rearrangement, Epstein-Barr virus status and p53 gene mutation of cutaneous extranodal NK/T-cell lymphoma, nasal-type / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Extranodal natural killer/T-cell (NK/T cell) lymphoma, nasal-type, is a rare lymphoma. Skin is the second most common site of involvement after the nasal cavity/nasalpharynx. The aim of this study was to investigate the clinicopathologic features, immunophenotype, T cell receptor (TCR) gene rearrangement, the association with Epstein-Barr virus (EBV) infection and p53 gene mutations of the lymphoma.</p><p><b>METHODS</b>The clinicopathologic analysis, immunohistochemistry, in situ hybridization for EBER1/2, TCR gene rearrangement by polymerase chain reaction (PCR), mutations of p53 gene analyzed by PCR and sequence analysis were employed in this study.</p><p><b>RESULTS</b>In the 19 cases, the tumor primarily involved the dermis and subcutaneous layer. Immunohistochemical staining showed that most of the cases expressed CD45RO, CD56, CD3ε, TIA-1 and GrB. Three cases were positive for CD3 and two cases were positive for CD30. Monoclonal TCRγ gene rearrangement was found in 7 of 18 cases. The positive rate of EBER1/2 was 100%. No p53 gene mutation was detected on the exon 4 - 9 in the 18 cases. Fifteen cases showed Pro (proline)/Arg (arginine) single nucleotide polymorphisms (SNPs) on the exon 4 at codon 72. The expression of p53 protein was 72% (13/18) immunohistochemically.</p><p><b>CONCLUSIONS</b>Cutaneous NK/T-cell lymphoma is a rare but highly aggressive lymphoma with poor prognosis. No p53 gene mutation was detected on the exon 4 - 9, and Pro/Arg SNPs on p53 codon 72 were detected in the cutaneous NK/T-cell lymphoma. The overexpression of p53 protein may not be the result of p53 gene mutation.</p>

Expressions of survivin and Ki67 and their significance in cutaneous extranodal NK/T-cell lymphoma,nasal type / 中华皮肤科杂志

Objective To investigate the expressions of survivin and Ki67 in cutaneous extranodal NK/T-cell lymphoma,nasal type and their significance.Methods Clinical data and laboratory test results were collected from 15 cases of cutaneous extranodal NK/T-cell lymphoma,nasal type with skin lesions as the initial manifestation.Immunohistochemical SP method was used to measure the expression of survivin and Ki67 in tissue sections from the lesions of these patients.To determine the percentage of survivin-or Ki67-positive cells,200 tumor cells were counted in a high power field (HPF) and 5 HPFs were observed in 1 section.Results There were 10 males and 5 females among the 15 patients,with the median age at diagnosis being 28.7 (range:9-62) years.Immunohistochemical study showed that the lesional tissue was positive for CD56 in 9 cases,CD3ε in 13 cases,T cell intracellular antigen (TIA)-1 in 15 cases,granzyme B in 10 cases,CD3 in 2 cases,βF1 in 1 case,but negative for CD4,CD5,CD8,CD20,and CD79α.All the 15 cases were positive for 1 or 2 T-cell associated antigens (CD2,CD7 or CD45RO).CD30 was observed in large tumor cells in 3 of the 15 cases.Monoclonal TCR-γ gene rearrangement was found in 3 of 14 cases.In situ hybridization for EBER1/2 was positive in all of the 15 cases.Survivin and Ki67 were expressed in 73.3％ (11/15) and 100％ (14/14,note:a tissue section was unavailable because of the detachment of tissue from the slide) of the specimens respectively,with the average percentage of positive cells being 23.97％ ± 18.35％ and 41.20％ ± 19.52％ for survivin and Ki67,respectively.Statistical differences were observed in the percentage of Ki67-expressing cells between the specimens with 0-2 mitotic figures per high power field from 9 cases and those with more than 2 mitotic figures from 6 cases (25.27％ ± 12.96％ vs.58.23％ ± 16.02％,F =19.14,P =0.001).No correlation was found between the expression of survivin and Ki67 in cutaneous extranodal NK/T-cell lymphoma,nasal type.Conclusion The high expressions of survivin and Ki67 may play a role in the occurrence and development of cutaneous extranodal NK/T-cell lymphoma,nasal type.

Diagnostic significance of immunophenotyping and detection of gene rearrangement in subcutaneous panniculitis-like T-cell lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the diagnostic implication of immunophenotyping and gene rearrangement in subcutaneous panniculitis-like T-cell lymphoma (SPTL).</p><p><b>METHODS</b>According to the selection criteria of 2005 WHO-EORTC classification for cutaneous lymphomas, 20 SPTL patients were enrolled in this study. A 10-antibody panel was used for immunophenotyping and in addition, polymerase chain reaction for TCR gamma and IgH gene rearrangement and in situ hybridization for EBER1/2 were also employed.</p><p><b>RESULTS</b>There were 9 males and 11 female with a mean age of 29.5 years. Immunophenotypic study showed that all the patients expressed one to three T-cell associated antigens (CD2, CD3 or CD45RO), 18 patients were positive for beta F1, 18 for CD8, 20 for TIA-1 and 16 for granzyme B. None of the patients expressed CD4, CD20 and CD56. TCR gamma gene rearrangement was found in 16 of 20 cases (80.0%) and none for IgH gene rearrangement. The positive rate of EBER1/2 was 25.0% (5/20).</p><p><b>CONCLUSIONS</b>Since the majority of SPTL patients show clonal TCR gene rearrangements, correlations among clinical presentation, histological features, immunophenotype and gene rearrangement data are considered important in confirming a diagnosis of SPTL.</p>