Clinicopathologic Study of Mature T-Cell Lymphoma with B-Cell Markers: A Review of 21 Cases
Fina Climent, Stefania Pittaluga, Daniel Martinez, Eva Gonzalez-Barca, Vicens Romagosa, Mark Raffeld, Elias Campo, Elaine S Jaffe. Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; National Cancer Institute, NIH, Bethesda, MD; Hospital Clinic, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
Background: Mature T-cell lymphomas (TCL) with expression of B-cell markers are rare. The spectrum of the disease has not been well characterized.
Design: We collected cases from the authors' institutions based on the coexpression of CD20 and/or CD79a in mature TCLs. The clinical, pathological, immunophenotypical and molecular findings were reviewed.
Results: Our series comprised 17 men and 4 women with a median age of 64 years (range: 42-79). Involved sites were lymph nodes (62%), skin (24%), bowel (10%) and adrenal gland (4%). Five patients presented with involvement of multiple sites. CD20 and CD79a were expressed in 18 (85%) cases and 10 (48%) cases, respectively. In 4 cases, the proportion of CD20+ T-cells changed over time. CD30, CD15 and cytotoxic markers were positive in 60%, 50% and 67% of tested cases, respectively. A clonal T-cell population was identified by molecular genetic analysis in 100% of tested cases. The cases were classified as peripheral T-cell lymphoma unspecified (n=13), angioimmunoblastic T-cell lymphoma (n=3), Mycosis Fungoides (n=3), indolent CD8 + lymphoid proliferation of the ear (n=1) and enteropathy-associated T-cell lymphoma (n=1). Clinical follow-up was obtained for 11 cases; 9 cases behaved aggressively with death from disease within 4 years of diagnosis (median survival: 16 mo, range: 1 to 48 mo). Two patients were alive with disease at four and three months, respectively.
Conclusions: Mature TCL with B-cell markers have a broad clinical and pathologic spectrum. It occurs in elderly males and some cases behave aggressively. The finding of CD20/CD79a positivity raises the differential diagnosis of B-cell lymphoma. Knowledge of this unusual phenomenon, careful morphologic evaluation, a broad panel of antibodies and molecular genetic studies, is important in avoiding a misdiagnosis of B-cell lymphoma.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 197, Wednesday Morning