Document Detail


Angioimmunoblastic T-cell lymphoma in bone marrow: a morphologic and immunophenotypic study.
MedLine Citation:
PMID:  19740519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Angioimmunoblastic T-cell lymphoma is known to frequently involve bone marrow. However, the histologic and immunophenotypic features of angioimmunoblastic T-cell lymphoma at this site are poorly defined. We assessed 27 bone marrow specimens involved by angioimmunoblastic T-cell lymphoma from 20 patients. Histologically, bone marrow involvement was predominantly multifocal (74%) and exhibited a nodular pattern (78%), often associated with other patterns. Using immunohistochemistry, programed death-1 and CD10 were expressed by atypical lymphocytes in 17 (85%) of 20 and 5 (18.5%) of 27 specimens, respectively. CXCL13 was not expressed by atypical lymphocytes in all cases but did stain stromal cells consistent with follicular dendritic cells in 1 case. BCL-6 as a single antibody was difficult to interpret because many normal bone marrow cells are dimly positive, but BCL-6/CD3 dual staining highlighted BCL-6+ T-cells in all cases assessed. Antibodies specific for CD21 and CD35 did not highlight follicular dendritic cells in any biopsy specimens. Flow cytometry immunophenotyping revealed a CD3+CD10+ T-cell population in 2 (25%) of 8 cases assessed. We conclude that the recognition and classification of angioimmunoblastic T-cell lymphoma in bone marrow are made difficult by the uncommon expression of CD10 (25%), rarity of follicular dendritic cells, and lack of CXCL13 expression at this site. This is most likely attributable to the very different microenvironment of the bone marrow relative to lymph nodes and, in particular, the absence of follicles in bone marrow. By contrast, programed death-1 immunohistochemical staining and double labeling using antibodies specific for BCL-6 and CD3 were helpful in appreciating the follicular T-helper cell immunophenotype of angioimmunoblastic T-cell lymphoma.
Authors:
Faisal A Khokhar; William D Payne; Sameer S Talwalkar; Jeffrey L Jorgensen; Carlos E Bueso-Ramos; L Jeffrey Medeiros; Francisco Vega
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Publication Detail:
Type:  Journal Article     Date:  2009-09-08
Journal Detail:
Title:  Human pathology     Volume:  41     ISSN:  1532-8392     ISO Abbreviation:  Hum. Pathol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2009-12-22     Revised Date:  2011-03-30    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-87     Citation Subset:  IM    
Affiliation:
Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. fvegava@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antigens, CD / metabolism
Bone Marrow Cells / metabolism,  pathology*
Chemokine CXCL13 / metabolism
DNA-Binding Proteins / metabolism
Female
Flow Cytometry
Humans
Immunoblastic Lymphadenopathy / metabolism,  pathology*
Immunophenotyping
Intercellular Signaling Peptides and Proteins / metabolism
Lymphoma, T-Cell / metabolism,  pathology*
Male
Middle Aged
Neprilysin / metabolism
Tumor Markers, Biological / metabolism
Young Adult
Chemical
Reg. No./Substance:
0/Antigens, CD; 0/B7-DC antigen; 0/BCL6 protein, human; 0/CXCL13 protein, human; 0/Chemokine CXCL13; 0/DNA-Binding Proteins; 0/Intercellular Signaling Peptides and Proteins; 0/Tumor Markers, Biological; EC 3.4.24.11/Neprilysin

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