Differential diagnosis of angioimmunoblastic T-cell lymphoma with seropositivity for anti-HTLV antibody from adult T-cell leukemia/lymphoma. 2010

Shih-Sung Chuang, and Ryo Ichinohasama, and Jan-Show Chu, and Koichi Ohshima
Department of Pathology, Chi-Mei Medical Center, Yung-Kang City, Tainan County, Taiwan. cmh5301@mail.chimei.org.tw

Angioimmunoblastic lymphoma (AITL) is a nodal peripheral T-cell lymphoma characterized by a proliferation of arborizing vessels and hyperplastic follicular dendritic cells as well as a polymorphous lymphoid infiltrate including neoplastic cells with clear cytoplasm. Adult T-cell leukemia/lymphoma (ATLL) is caused by the retrovirus human T-cell leukemia virus type I (HTLV-I), and the neoplastic cells are usually large and pleomorphic. Recently, a rare morphologic variant of ATLL with AITL-like features has been reported. Here, we presented a case of peripheral T-cell lymphoma with morphological features of AITL in Taiwan, a country non-endemic for HTLV, and the patient was seropositive for anti-HTLV antibody, which raised the possibility of ATLL with AITL-like features. Immunohistochemically, there were hyperplastic follicular dendritic meshworks by CD21 immunostaining, and the neoplastic cells expressed CD10, programmed death-1, and CXCL13. Furthermore, Southern blot analysis using DNA extracted from the nodal tissue was negative for HTLV-I proviral integration. Our investigations indicated that in an HTLV-I non-endemic area, a peripheral T-cell lymphoma with typical morphologic and immunophenotypic features of AITL could be confidently diagnosed as AITL even if the patient was seropositive for anti-HTLV antibody.

UI MeSH Term Description Entries
D007119 Immunoblastic Lymphadenopathy A disorder characterized by proliferation of arborizing small vessels, prominent immunoblastic proliferations and amorphous acidophilic interstitial material. Clinical manifestations include fever, sweats, weight loss, generalized lymphadenopathy and frequently hepatosplenomegaly. Angioimmunoblastic Lymphadenopathy,Lymphadenopathy, Immunoblastic,Angioimmunoblastic Lymphadenopathies,Immunoblastic Lymphadenopathies,Lymphadenopathies, Angioimmunoblastic,Lymphadenopathies, Immunoblastic,Lymphadenopathy, Angioimmunoblastic
D008198 Lymph Nodes They are oval or bean shaped bodies (1 - 30 mm in diameter) located along the lymphatic system. Lymph Node,Node, Lymph,Nodes, Lymph
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001706 Biopsy Removal and pathologic examination of specimens from the living body. Biopsies
D015481 HTLV-I Antibodies Antibodies reactive with the HTLV-I ANTIGENS. ATLV Antibodies,Human T-Cell Leukemia Virus I Antibodies,Leukemia-Lymphoma Virus I Antibodies, Human T-Cell,T-Cell Leukemia Virus I Antibodies, Adult,T-Cell Leukemia Virus I Antibodies, Human,HTLV I Antibodies,Human T Cell Leukemia Virus I Antibodies,Leukemia Lymphoma Virus I Antibodies, Human T Cell,T Cell Leukemia Virus I Antibodies, Adult,T Cell Leukemia Virus I Antibodies, Human,Antibodies, ATLV,Antibodies, HTLV I,Antibodies, HTLV-I,I Antibodies, HTLV
D015490 HTLV-I Infections Diseases caused by HUMAN T-LYMPHOTROPIC VIRUS 1. Human T-lymphotropic Virus 1 Infection,Human T-lymphotropic Virus 1 Infections,Infections, HTLV-I,HTLV I Infections,HTLV-I Infection,Human T lymphotropic Virus 1 Infection,Human T lymphotropic Virus 1 Infections,Infection, HTLV-I,Infections, HTLV I
D016399 Lymphoma, T-Cell A group of heterogeneous lymphoid tumors representing malignant transformations of T-lymphocytes. T-Cell Lymphoma,Lymphoma, T Cell,Lymphomas, T-Cell,T Cell Lymphoma,T-Cell Lymphomas

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