Morphologic and immunophenotypic analysis of angioimmunoblastic T-cell lymphoma: Emphasis on phenotypic aberrancies for early diagnosis

Am J Clin Pathol. 2006 Jul;126(1):29-38. doi: 10.1309/28YP-0DEL-GKEJ-GRXG.

Abstract

The morphologic features and immunophenotype of diagnostic nodal and bone marrow biopsy specimens were reviewed in 29 well-established cases of angioimmunoblastic T-cell lymphoma (AILT). All cases showed a characteristic polymorphous lymphoid and inflammatory cell infiltrate along with stromal-vascular changes. Perivascular aggregation or clustering of neoplastic clear cells was seen in only 41% of cases. Unique architectural changes, including extranodal extension (83%), follicular dendritic cell proliferation (93%), and a distinctly marginalized distribution of residual B cells (67%) were observed. Subsets of T cells with immunophenotypic abnormalities (CD10 coexpression or loss of pan-T-cell antigens CD3 and CD7) were identified in a majority of cases (96%). Significantly, these morphologic and phenotypic features were seen irrespective of the presence of an overt lymphomatous pattern. Bone marrow involvement was present in 90% of patients with available biopsy specimens. Our results indicate that unique morphologic alterations and subsets of phenotypically aberrant T cells are present consistently in nearly all cases of AILT, including morphologically less definitive biopsy specimens.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, CD / metabolism
  • Biomarkers, Tumor / metabolism
  • Bone Marrow / metabolism
  • Bone Marrow / pathology
  • DNA, Neoplasm / analysis
  • Dendritic Cells, Follicular / metabolism
  • Dendritic Cells, Follicular / pathology
  • Early Diagnosis
  • Female
  • Flow Cytometry
  • Humans
  • Immunoblastic Lymphadenopathy / immunology
  • Immunoblastic Lymphadenopathy / metabolism
  • Immunoblastic Lymphadenopathy / pathology*
  • Immunophenotyping / methods*
  • Lymph Nodes / metabolism
  • Lymph Nodes / pathology
  • Lymphoma, T-Cell / immunology
  • Lymphoma, T-Cell / metabolism
  • Lymphoma, T-Cell / pathology*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • T-Lymphocyte Subsets / metabolism
  • T-Lymphocyte Subsets / pathology

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • DNA, Neoplasm