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Composite angioimmunoblastic T-cell lymphoma and diffuse large B-cell lymphoma: a case report and review of the literature. Am J Clin Pathol 2002 Dec;118(6):848-54

Date

12/11/2002

Pubmed ID

12472277

DOI

10.1309/VD2D-98ME-MB3F-WH34

Scopus ID

2-s2.0-0036884642   55 Citations

Abstract

We report a rare case of composite angioimmunoblastic T-cell lymphoma (AILT) and diffuse large B-cell lymphoma occurring in a 48-year-old woman with generalized lymphadenopathy and hepatosplenomegaly. The patient initially sought care at a local hospital with a single enlarged left cervical lymph node. Histologic examination of the node was interpreted as an atypical immunoblastic proliferation. She developed generalized lymphadenopathy 10 months later and was referred to our institution for further evaluation. The recent biopsy of the cervical node showed typical features of AILT Flow cytometric immunophenotyping identified an aberrant CD4+ T-cell population that lacked surface CD3. Polymerase chain reaction analysis of the T-cell receptor gamma gene revealed a clonal rearrangement. In addition to the AILT, the lymph node showed partial involvement by a diffuse large B-cell lymphoma. The B lymphoma cells and admixed immnunoblasts and Reed-Sternberg-like B cells in the AILT were positive for Epstein-Barr virus (EBV) by in situ hybridization. Ourfindings raise the possibility that the EBV-associated large B-cell lymphoma is a secondary event in AILT via EBV infection or reactivation followed by clonal expansion of an immortalized EBV-infected B cell clone.

Author List

Xu Y, McKenna RW, Hoang MP, Collins RH, Kroft SH

Author

Steven Howard Kroft MD Chair, Professor in the Pathology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Epstein-Barr Virus Infections
Female
Flow Cytometry
Genes, Immunoglobulin
Genes, T-Cell Receptor gamma
Herpesvirus 4, Human
Humans
Immunophenotyping
In Situ Hybridization
Lymphoma, Large B-Cell, Diffuse
Lymphoma, T-Cell
Middle Aged
Polymerase Chain Reaction