HAEM5:Enteropathy-associated T-cell lymphoma: Difference between revisions
| [unchecked revision] | [unchecked revision] |
Fnu.Monika (talk | contribs) No edit summary |
Fnu.Monika (talk | contribs) No edit summary |
||
| Line 82: | Line 82: | ||
==Morphologic Features== | ==Morphologic Features== | ||
*Pleomorphic medium to large neoplastic lymphoid | *'''Pleomorphic medium to large sized neoplastic lymphoid cells with immunoblastic or anaplastic morphology.<ref name=":2" /><ref name=":5" />''' | ||
*'''Angulated vesicular nuclei, prominent nucleoli, and a pale-staining cytoplasm [https://doi.org/10.3390/diagnostics13162629<nowiki>]</nowiki>''' | |||
*'''Extensive inflammatory background of histiocytes, eosinophils, small lymphocytes, and plasma cells <ref name=":5" />''' | |||
*'''Adjacent mucosa often displays the histological features of active CD, including increased IEL infiltration, crypt hyperplasia, and villous atrophy <ref name=":2" /><ref name=":5" /> [https://doi.org/10.3390/diagnostics13162629<nowiki>]</nowiki>''' | |||
*'''Angioinvasion and angiodestruction are commonly seen''' <ref name=":5" /> | |||
* | |||
* | |||
*Neighborhood mucosa characterized by villous atrophy and crypt hyperplasia (non-malignant areas of celiac disease)<ref name=":2" /> | *Neighborhood mucosa characterized by villous atrophy and crypt hyperplasia (non-malignant areas of celiac disease)<ref name=":2" /> | ||
*Round or angulated vesicular nuclei<ref name=":2" /> | *Round or angulated vesicular nuclei<ref name=":2" /> | ||
| Line 90: | Line 96: | ||
*Angiocentric and angioinvasive features with extensive necrosis<ref name=":2" /> | *Angiocentric and angioinvasive features with extensive necrosis<ref name=":2" /> | ||
<br /> | |||
==Immunophenotype== | ==Immunophenotype== | ||
* '''The most common immunophenotypic profile in EATL is given below:''' | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
| Line 108: | Line 115: | ||
|} | |} | ||
{| class="wikitable | * '''Approximately 25% of EATLs (primarily de novo EATL) are CD8+, and rare cases express TCRγδ [23313469, 26462278]''' | ||
| | * '''Ki-67 is very low and CD30 is negative in RCDII, their appearance is useful to monitor RCDII progression to EATL and to indicate the need for chemotherapeutic regimens targeting dividing cells, a therapeutic option that is inefficient and even dangerous in RCDII. <u>33579790</u>''' | ||
! | |||
!Type 1 RCD | {| class="wikitable" | ||
|+ | |||
! | |||
!RCD Type 1 | |||
!RCD Type 2 | |||
!EATL | |||
|- | |- | ||
| | |'''Histopathology''' | ||
| || | |Identical to uncomplicated CD | ||
|Moderate/ severe villous atrophy with atypical IELs | |||
|Infiltration of medium to large sized pleomorphic IELs | |||
|- | |- | ||
| | |'''IEL Immunophenotype''' | ||
| || | |Like CD; sCD3+, CD8+ | ||
| | |||
| | |||
|- | |- | ||
| | | | ||
| || | | | ||
| | |||
| | |||
|} | |} | ||
Immunophenotype of intraepithelial lymphocytes (IEL):<ref name=":7">{{Cite journal|last=P|first=Domizio|last2=Ra|first2=Owen|last3=Na|first3=Shepherd|last4=Ic|first4=Talbot|last5=Aj|first5=Norton|date=1993|title=Primary lymphoma of the small intestine. A clinicopathological study of 119 cases|url=https://pubmed.ncbi.nlm.nih.gov/8470758/|language=en|pmid=8470758}}</ref><ref name=":0">{{Cite journal|last=Deleeuw|first=Ronald J.|last2=Zettl|first2=Andreas|last3=Klinker|first3=Erdwine|last4=Haralambieva|first4=Eugenia|last5=Trottier|first5=Magan|last6=Chari|first6=Raj|last7=Ge|first7=Yong|last8=Gascoyne|first8=Randy D.|last9=Chott|first9=Andreas|date=2007-05|title=Whole-genome analysis and HLA genotyping of enteropathy-type T-cell lymphoma reveals 2 distinct lymphoma subtypes|url=https://pubmed.ncbi.nlm.nih.gov/17484883|journal=Gastroenterology|volume=132|issue=5|pages=1902–1911|doi=10.1053/j.gastro.2007.03.036|issn=0016-5085|pmid=17484883}}</ref> | Immunophenotype of intraepithelial lymphocytes (IEL):<ref name=":7">{{Cite journal|last=P|first=Domizio|last2=Ra|first2=Owen|last3=Na|first3=Shepherd|last4=Ic|first4=Talbot|last5=Aj|first5=Norton|date=1993|title=Primary lymphoma of the small intestine. A clinicopathological study of 119 cases|url=https://pubmed.ncbi.nlm.nih.gov/8470758/|language=en|pmid=8470758}}</ref><ref name=":0">{{Cite journal|last=Deleeuw|first=Ronald J.|last2=Zettl|first2=Andreas|last3=Klinker|first3=Erdwine|last4=Haralambieva|first4=Eugenia|last5=Trottier|first5=Magan|last6=Chari|first6=Raj|last7=Ge|first7=Yong|last8=Gascoyne|first8=Randy D.|last9=Chott|first9=Andreas|date=2007-05|title=Whole-genome analysis and HLA genotyping of enteropathy-type T-cell lymphoma reveals 2 distinct lymphoma subtypes|url=https://pubmed.ncbi.nlm.nih.gov/17484883|journal=Gastroenterology|volume=132|issue=5|pages=1902–1911|doi=10.1053/j.gastro.2007.03.036|issn=0016-5085|pmid=17484883}}</ref> | ||
| Line 139: | Line 152: | ||
****NKP46: significantly more positive in RCD2 IEL than normal IEL in CD and RCD1; not specific for RCD2 or EATL, can be seen in [[HAEM5:Monomorphic epitheliotropic intestinal T-cell lymphoma|MEITL]]; not seen in [[HAEM5:Indolent T-cell lymphoma of the gastrointestinal tract|indolent T-cell LPD of GI tract]] | ****NKP46: significantly more positive in RCD2 IEL than normal IEL in CD and RCD1; not specific for RCD2 or EATL, can be seen in [[HAEM5:Monomorphic epitheliotropic intestinal T-cell lymphoma|MEITL]]; not seen in [[HAEM5:Indolent T-cell lymphoma of the gastrointestinal tract|indolent T-cell LPD of GI tract]] | ||
****CD30+ indicates progression to EATL | ****CD30+ indicates progression to EATL | ||
==Chromosomal Rearrangements (Gene Fusions)== | ==Chromosomal Rearrangements (Gene Fusions)== | ||