university of medicine and pharmacie tg. mureş international congress for students, young...
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University of Medicine and Pharmacie Tg. MureşInternational Congress for Students, Young Physicians and Pharmacists
Marisiensis 2014
Histological and immunohistochemical
findings in Peripheral T cell Lymphoma
Author: Buzdugan DumitriţaScientific coordinators: Şef lucr. Dr. Ovidiu S. Cotoi,
Conf. Dr. Mihai Turcu
Introduction
Peripheral T cell lymphoma (PTCL) is a type of lymphoproliferation of mature T cells (post thymic stage)
Rare, aggressive, with poor outcome
World Health Organization's classification, dating 2008, includes three subtypes of PTCL :
I PTCL – NOS (non otherwise specified)
Positive at normal T cell markers but with a down regulation of CD5, CD7
Aberrant expression of CD20, CD79a and CD30
Histologically there are known three variants: Lennert
Follicular T-zone
II PTCL - angioimmunoblastic
Positive at T cell markers: CD2, 3, 5, TCR
CD10, BCL-6, CXCL-13 positive – markers for T helper lymphocytes
important proliferation at endothelial arborization level
III PTCL - anaplastic
ALK +• CD30, 2, 4, 5, 25 positive and partially
positive at CD45 and CD45 RO• There have not been observed
antibodies for Epstein Barr virus
ALK –• CD30, 43 positive• Loss of T cell markers
Material and method
Retrospective descriptive study upon 29 patients diagnosed with PTCL between 2008 and 2013 diagnosed in the County Hospital of Tg. Mureş
Clinical criteria: site of primary tumorDemographic criteria: age and genderImmunohistochemical criteria:
presence of specific markers
Histological: in all PTCLs developed in the lymph nodes their structure was totally modified by the neoplasm
Aberrant expression of CD20: - 20 cases positive, but only in
remanent follicules and in low number
- 7 cases negative - 2 unspecified
Specific markers for vessels proliferation were found positive in the 2 cases of PTCL angioimmunoblastic
Results
Discussions
High incidence in men, fifth decade of life [1]
[5]
PTCL-NOS is the most common type of PTCLs with a 83% incidence (while in other studies it has shown a 25-30% incidence) [2][3]
Imprecise differentiation between PTCL-NOS and PTCL-anaplastic ALK- (both CD30 positive) high importance of genetic studies [4]
Significant decreasing incidence of PTCLs from 2008 to 2013 in this center of study
ConclusionsThe latest update of the WHO classification
has useful criteria for PTCL diagnostic
The information obtained in this study is in accordance with that from the specialized literature: high frequency in middle aged male with T cell markers expression maintained – CD3
Further studies about immunofenotyping must be correlated with genetic studies for a better treatment outcome
Limitations of the study:
Retrospective designRestricted to a single center’s
patientsSmall number of cases
ReferencesBettina Bisig, Aurelien de Reynies, Christophe Bonnet, et al:
CD30-positive peripheral T-cell lymphomas share molecular and phenotypic features. The Hematology Journal, 98: 1250-1258, 2013
Brenton T. Tan, Roger A. Warnke, Daniel A. Arber: The frequency of B- and T-Cell Gene Rearrangements and Epstein-Barr Virus in T-Cell Lymphomas. The Journal of Molecular Diagnostics, 8: 466-475, 2006
Harry L. Ioachim, L. Jeffery Medeiros: Ioachim’s Lymph Node Pathology, 4th edition
Julie M. Vose, Neumann M., Mildred E. Harris: International T-cell and Natural Killer/T-cell Lymphoma Study: Pathology findings and Clinical Outcomes. Journal of Clinical Oncology, 26:4124-4130, 2008 [1]
Laurence de Leval, Philippe Gaulard: CD30+ lymphoproliferative disorders. The Hematology Journal, 35 :1627-1630, 2010 [4]
Mihai Turcu, Angela Borda, Vasile Bud: Diagnosticul microscopic al leziunilor nodulului limfatic, ed. Mureş 1999
Philip Went, Claudio Agostinelli, Andrea Gallamini, et al. : Marker Expression in Peripheral T-cell Lymphoma: A proposed Clinical-Pathologic Prognostic Score. Journal of Clinical Oncology, 24: 2472-2479, 2006 [2]
Pier Paolo Piccaluga, Claudio Agostinelli, Anna Gazzola, et al.: Prognostic Markers in Peripheral T-cell Lymphoma. Current Hematologic Malignancy Reports, 5:222-228, 2010 [3]
Steven H. Swerdlow, Elias Campo, Nancy Lee Haris, et al: WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues, 4th edition. International Agency for Research on Cancer, Lyon, 2008 [5]