伴有明显淋巴滤泡的非特指外周T细胞淋巴瘤

目的　探讨伴有明显淋巴滤泡增生的非特指外周T细胞淋巴瘤的形态学特点和免疫表型。方法　对 3例特殊形态的外周T细胞淋巴瘤进行形态学观察 ,免疫组化EnVision法检测CD3、CD4 5RO、CD4 3、CD2 0、CD79a、cyclinD1、bcl 2、CD4、CD8、S 10 0等抗体 ,并用PCR方法进行T细胞受体(TCR)基因重排检测。结果　 3例患者均以全身浅表淋巴结肿大为主要表现 ,初发部位为颈部和颌下 ,发病过程中出现低热及全身皮疹 ,并有肝、脾肿大。形态学的显著特点为淋巴滤泡增生 ,套区消失 ,边缘区有中等大小、胞浆透亮的瘤细胞浸润生长。免疫表型标志为T细胞淋巴瘤。基因检测有TCRγ基因阳性条带。结论　部分非特指外周T细胞淋巴瘤可伴有明显淋巴滤泡增生 ,应注意与淋巴结反应性增生、滤泡性淋巴瘤、边缘区淋巴瘤及套区淋巴瘤等鉴别

Unspecified peripheral T cell lymphoma with distinct lymphoid follicles

OBJECTIVE: To investigate the morphological features and immunophenotype of unspecified peripheral T cell lymphoma with distinct lymphoid follicular growth pattern. METHODS: Three cases of peripheral T cell lymphoma with special pathohistological features were collected. Morphologic analysis and immunohistochemical staining for CD3, CD45RO, CD43, CD20, CD79a, cyclinD1, bcl-2, CD4, CD8 and S-100 were performed. PCR was used to study TCRgamma gene rearrangements. RESULTS: The main symptoms of all the three patients with the primary sites of cervix and lower jaw. There were intermittent fever and skin rashes in the course of the disease. Morphological study showed lymphoid follicular reactive hyperplasia, mantle zone disappear, prominent infiltration of marginal zones by medium-sized tumor cells with clear cytoplasm and significant nuclear atypia. The immunophenotypic profile confirmed that they were T cell lymphomas. TCRgamma gene rearrangements were found in all the three patients. CONCLUSION: In some unspecified peripheral T cell lymphomas, the distinct follicular growth pattern and incomplete effacement of the lymph node architecture make it necessary to differentiate them from reactive hyperplasia, marginal zone B cell lymphoma, follicular B cell lymphoma and mantle cell lymphoma.