Central Nervous System ; pathology ; Humans ; Lymphoma, T-Cell, Peripheral ; diagnosis

Burkitt Lymphoma ; diagnosis ; pathology ; Female ; Hodgkin Disease ; diagnosis ; pathology ; Humans ; Lymphoma ; classification ; diagnosis ; pathology ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; pathology ; Lymphoma, Follicular ; diagnosis ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; pathology

The majority of intestinal lymphoma is derived from B cells, and peripheral T-cell lymphoma-unspecified (PTCL-U) rarely invades the intestines and liver. We report a case of PTCL-U that invaded also the intestines and liver besides the lymph nodes, characterized by multiple irregular ulcers of the intestine and ileocecal junction, and multiple intrahepatic low density foci. The diagnosis was established by mucosal biopsy and pathological examination. This case highlights the possibility of PTCL-U involving uncommon organs, for which a definite diagnosis has to be established pathologically. PTCL-U is highly malignant with a poor prognosis, and so far no standard treatment strategy has been available.
Female ; Humans ; Intestines ; pathology ; Liver ; pathology ; Lymphoma, T-Cell, Peripheral ; diagnosis ; pathology ; Middle Aged

Dendritic Cells, Follicular ; pathology ; Diagnosis, Differential ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; pathology ; Lymphoma ; pathology ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Lymphoma, Follicular ; pathology ; Lymphoma, Large B-Cell, Diffuse ; pathology ; Lymphoma, Large-Cell, Anaplastic ; pathology ; Lymphoma, Mantle-Cell ; pathology ; Lymphoma, T-Cell, Peripheral ; pathology ; Neoplasm Invasiveness ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology

Primary intestinal T-cell lymphoma is a rare disease entity, which is approximately 10% to 25% of intestinal lymphomas, and most of the lymphomas occur in the small intestine. We report here a case of a 56-year-old woman who has been suffering from chronic diarrhea and weight loss for 6 months. Abdominal CT scan and small bowel series showed diffuse wall thickening of the small bowel. Gastroscopic examination showed diffuse erythematous lesions on the esophagus and small gastric ulcerations on the antrum of the stomach, and colonoscopic examination also showed multiple punched-out ulcerations and erosions on the entire colon, including the sigmoid colon to the terminal ileum. Diffuse infiltration of CD 3 positive lymphoma cells was found on biopsy. The patient was diagnosed as primary intestinal T-cell lymphoma with diffuse involvement of the entire gastrointestinal tracts from the esophagus to the rectum. Although the patient received systemic combination chemotherapy and achieved partial response initially, the lymphoma relapsed repeatedly.
Case Report ; Esophageal Neoplasms/therapy* ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/diagnosis ; Female ; Gastrointestinal Neoplasms/therapy* ; Gastrointestinal Neoplasms/pathology ; Gastrointestinal Neoplasms/diagnosis ; Human ; Lymphoma, T-Cell/therapy* ; Lymphoma, T-Cell/pathology ; Lymphoma, T-Cell/diagnosis ; Middle Age

This study was aimed to investigate the significance of detecting the antigen-receptor gene rearrangement clonality in the diagnosis of lymphoma. Paraffin-embedding and HE staining of samples from 31 patients with lymphomas were performed for morphologic observation by light microscope. Immunophenotype was analyzed by the immunohistochemistry (IHC) method. The clonality of antigen-receptor gene rearrangement was detected by BIOMED-2 Assay Kit. The results showed that among the 31 cases, 12 cases were suspected to be T-cell lymphoma, 1 case was suspected to be T-cell reactive hyperplasia, and 16 cases were suspected to be B-cell lymphoma, 2 cases were B-cell reactive hyperplasia. The detection results showed that the positivity of Ig gene rearrangement clonality was 94.44% (17/18), the positivity of TCR gene rearrangement clonality was 92.31% (12/13), the other two cases were negative. Finally, 12 cases were diagnosed to be T-cell lymphoma and 17 cases were B-cell lymphoma. The other two cases were reactive lymphoid proliferations. And the positivity rate in the 31 patients with lymphomas was 93%. It is concluded that the detection of antigen-receptor gene rearrangement clonality is a useful assistant method in the diagnosis of lymphoma.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Gene Rearrangement, T-Lymphocyte ; Humans ; Lymphoma ; diagnosis ; pathology ; Lymphoma, B-Cell ; diagnosis ; pathology ; Lymphoma, T-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Receptors, Antigen, T-Cell ; genetics ; Young Adult

Intravascular lymphomatosis (IL) is a rare and generally fatal disease characterized by proliferation of large lymphoma cells almost exclusively within the lumen of small blood vessels. The skin and central nervous systems are typically affected, but involvement of other organs, such as lung, has been described. Predominant lung involvement without cutaneous and neurologic manifestation is very rare and difficult to diagnose. Originally considered as an endothelial disorder, IL has recently been reclassified as lymphoma. Most of the cases reported are of B cell lineage with a few cases of T cell type. We describe a case of the T-cell type IL manifested clinically as an interstitial lung disease without involvement of skin and central nervous systems. Immunohistochemical studies showed the T-cell nature of the neoplastic cells in open lung biopsy sample.
Blood Vessels/pathology ; Case Report ; Diagnosis, Differential ; Fatal Outcome ; Human ; Lung Diseases, Interstitial/pathology* ; Lymphoma, T-Cell/physiopathology ; Lymphoma, T-Cell/pathology* ; Lymphoma, T-Cell/immunology ; Male ; Middle Age ; Tomography Scanners, X-Ray Computed

Extranodal NK/T-cell lymphoma, nasal type (ENKT), is a distinct clinicopathologic disease, common among East Asia and Latin America population. Clinically, it frequently occurs in middle-aged men. It predominantly occurs in the nasal or paranasal areas and less frequently in the skin. The main clinical features are nasal congestion, sore throat, dysphagia and epistaxis, due to a destructive mass involving the midline facial tissues. The pathogenesis of ENKT remains uncertain. It is thought that Epstein-Barr virus (EBV) may play a role in the development of this entity. Pathologically, lymphoma cells exhibit angioinvasion, angiodestruction and coagulative necrosis. It has unique characteristics including the expression of cytoplasmic CD3, CD56 and cytotoxic molecules such as TIA-1, and is positive for EBV in situ hybridization. The overall prognosis of this disease is poor because of frequent relapse or resistance to treatment. Although several studies have explored the treatment of ENKL in recent years, the optimal therapy has still not been found. Due to the highly aggressive features of tumors, every endeavor has been made to investigate factors associated with poor outcome. In this review, the recent advances on cause and pathogenesis, clinical manifestations and staging, pathologic characteristics, diagnosis and differential diagnosis, therapy and prognosis of ENKL are summarized.
Diagnosis, Differential ; Humans ; Lymphoma, T-Cell ; diagnosis ; etiology ; pathology ; therapy ; Neoplasm Staging ; Nose Neoplasms ; diagnosis ; etiology ; pathology ; therapy

One case of arthritis complicating leukemia is described in which leukemic cells were identified in synovial fluid by light microscopy. Although arthritis is a well-known manifestation of leukemia with an incidence of 13.5%, the pathogenesis often is unclear, and the direct demonstration of leukemic cells in synovial fluid has been very uncommon. A 16 year-old male patient was admitted due to left elbow joint pain and swelling. Synovial fluid examination revealed blast cells and this finding has directed to a final diagnosis of acute lymphoblastic leukemia.
Adolescent ; Arthritis/*etiology ; Humans ; Leukemia-Lymphoma, Adult T-Cell/*complications/diagnosis/pathology ; Male

OBJECTIVETo report the diagnosis, differential diagnosis and treatment of a rare case of primary bone marrow CD8+ cytotoxic T-cell lymphoma coexpressed CD20.

METHODSThe clinical characteristics, therapeutic course and the outcome of this patient were reviewed. Meanwhile, a series of examinations including morphology, flow cytometry, immunohistochemistry and molecular biology of bone marrow and skin samples were also performed.

RESULTSBone marrow biopsy showed an extensive involvement by abnormal T lymphocytes. Flow cytometry and immunohistochemistry showed weakly positive CD20, CD8(+), CD2(+), CD3(+), CD5(+), TIA(+), PAX-5(-), CD4(-), CD56(-), CD57(-), CD30(-), ALK-1(-), P53(-), TdT(-), Ki-67≈5%. A final diagnosis of primary bone marrow CD8+ cytotoxic T-cell lymphoma coexpressed CD20 was made. The patient initially presented a relatively indolent course was, but he was expired in the end 3 years later due to extensive involvements of skin and other organs though timely therapy was administrated.

CONCLUSIONPrimary bone marrow CD8 cytotoxic T-cell lymphoma coexpressed CD20 was encountered rarely in clinical practice, which might be a challenging in terms of diagnosis and differential diagnosis. Further investigation of pathogenesis and therapeutic strategies of this rare disease was warranted.

Antigens, CD20 ; metabolism ; CD8-Positive T-Lymphocytes ; metabolism ; pathology ; Humans ; Lymphoma, T-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; metabolism ; pathology