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Diagn Pathol. 2013 Jan 9;8:2. doi: 10.1186/1746-1596-8-2.

Paediatric T-cell lymphoma of the appendix: a case report.

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1
Laboratory of Pathology, Chidoribashi Hospital, 5-18-1 Chiyo, Fukuoka 812-8633, Japan.

Abstract

A 7-year-old boy with no history of malnutrition or diarrhoea complained of acute abdominal pain, was diagnosed with acute appendicitis, and underwent appendectomy. Histologically, a diffuse infiltrate of large atypical lymphoid cells was found in the entire appendiceal wall. Immunohistochemical examination revealed that the tumour cells expressed T-cell receptor (TCR)-βF1, CD3, CD4, CD25, cytotoxic-related protein TIA1 and granzyme-B, but were negative for CD8, Foxp3, CD20, CD30 and CD56. Polymerase chain reaction (PCR) revealed clonal bands of TCR-γ gene products in the tumour tissue. No anti-cytomegalovirus antibody-positive cells were detected. In situ hybridization revealed no nuclear signals of Epstein-Barr virus (EBV)-encoded RNA. Helicobacter pylori infection was detected in tumour tissue by anti-East Asian cytotoxin-associated gene (Cag) A antibody and PCR using its specific primers. The patient received chemotherapy and has remained in remission for 2 years. To the best of our knowledge, only two cases of appendiceal T-cell non-Hodgkin lymphoma (NHL) have been reported, both in elderly patients. We believe that this is the first reported case of childhood CD4- and TIA1-positive cytotoxic T (Th1)-cell NHL in the appendix or gastrointestinal tract. Helicobacter pylori infection might be an initiator of atypical cytotoxic T-cell proliferation.

VIRTUAL SLIDES:

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1302380563830412.

PMID:
23302373
PMCID:
PMC3546902
DOI:
10.1186/1746-1596-8-2
[Indexed for MEDLINE]
Free PMC Article
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