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Peripheral T-cell Lymphoma with Cyclin D1 overexpression: a case report.

Aquino G, Franco R, Ronconi F, Anniciello A, Russo L, De Chiara A, Panico L - Diagn Pathol (2012)

Bottom Line: Peripheral T-cell lymphomas not otherwise specified are generally considered aggressive non-Hodgkin lymphomas, because of poor natural outcome and response to therapy.They show a complex karyotype without any specific genetic hallmark.Several pitfalls could lead to misinterpretation of diagnosis, therefore, we underlined the need to integrate the classical histology and immunohistochemistry with molecular tests as clonality or fluorescence in situ hybridization.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pathology Unit, National Cancer Institute Fondazione Giovanni Pascale, Via Mariano Semmola, 80131 Napoli, Italy.

ABSTRACT

Unlabelled: Peripheral T-cell lymphomas not otherwise specified are generally considered aggressive non-Hodgkin lymphomas, because of poor natural outcome and response to therapy. They show a complex karyotype without any specific genetic hallmark. We report a case of peripheral T-cell lymphoma not otherwise specified with heterogeneous nuclear cyclin D1 immunohistochemical overexpression, due to gene copy gain, a phenomenon similar to that observed in mantle cell lymphoma characterized by t(11;14)(q13;q32). In this case report we underline the diagnostic pitfall represented by cyclin D1 immunohistochemical overexpression in a T-cell lymphoma. Several pitfalls could lead to misinterpretation of diagnosis, therefore, we underlined the need to integrate the classical histology and immunohistochemistry with molecular tests as clonality or fluorescence in situ hybridization.

Virtual slide: The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1117747619703769.

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Photomicrographs of Peripheral T cell lymphoma morphology and immunostaining. (A) and (B) hematoxylin and eosin morphology 20X and 100X magnification respectively. C) CD 20 immunostaining (40X magnification). D) strong CD3 positivity (20X magnification). E) CD5 immunostaining positivity (40X magnification). F) CD43 expression (40X magnification).
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Figure 1: Photomicrographs of Peripheral T cell lymphoma morphology and immunostaining. (A) and (B) hematoxylin and eosin morphology 20X and 100X magnification respectively. C) CD 20 immunostaining (40X magnification). D) strong CD3 positivity (20X magnification). E) CD5 immunostaining positivity (40X magnification). F) CD43 expression (40X magnification).

Mentions: A 74 year old man was admitted to Hematology Unit of Moscati Hospital, Avellino, because of multiple superficial adenopathies, splenomegaly and bilateral lower limbs lymphedema. Laboratory data revealed elevated LDH levels, hyperuricemia and positivity for hepatitis B antibodies. Peripheral blood counts were normal, since leucocitosi was not found. Parametres are as follows: white blood cells count (WBC) 8500/mmc (Neutrophilis 73.5%; Leukocytes 20.8% Monocytes 5,5%); red blood cells count (RBC) 3.970000/mmc Haemoglobin (Hb) 13,4 g/dl; hematocrit (HCT) 38.3%; mean corpuscular volume (MCV) 96,4 Platelet count (PLT) 129.000/mmc. On the basis of this clinical presentation and histological findings was excluded a diagnosis of lymphoma with a leukemic presentation. CT (computed tomography) scan showed multiple deep and superficial lymph-nodes enlargement in the neck, thorax and abdomen. Focal hypoechoic lesions were detectable in the spleen. A latero-cervical/submandibular nodal biopsy was performed for diagnosis purpose. The specimen was fixed in 10% neutral buffered formalin and paraffin embedded. Five microns thick sections were stained with hematoxylin and eosin for histological examination (Figure1).


Peripheral T-cell Lymphoma with Cyclin D1 overexpression: a case report.

Aquino G, Franco R, Ronconi F, Anniciello A, Russo L, De Chiara A, Panico L - Diagn Pathol (2012)

Photomicrographs of Peripheral T cell lymphoma morphology and immunostaining. (A) and (B) hematoxylin and eosin morphology 20X and 100X magnification respectively. C) CD 20 immunostaining (40X magnification). D) strong CD3 positivity (20X magnification). E) CD5 immunostaining positivity (40X magnification). F) CD43 expression (40X magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475098&req=5

Figure 1: Photomicrographs of Peripheral T cell lymphoma morphology and immunostaining. (A) and (B) hematoxylin and eosin morphology 20X and 100X magnification respectively. C) CD 20 immunostaining (40X magnification). D) strong CD3 positivity (20X magnification). E) CD5 immunostaining positivity (40X magnification). F) CD43 expression (40X magnification).
Mentions: A 74 year old man was admitted to Hematology Unit of Moscati Hospital, Avellino, because of multiple superficial adenopathies, splenomegaly and bilateral lower limbs lymphedema. Laboratory data revealed elevated LDH levels, hyperuricemia and positivity for hepatitis B antibodies. Peripheral blood counts were normal, since leucocitosi was not found. Parametres are as follows: white blood cells count (WBC) 8500/mmc (Neutrophilis 73.5%; Leukocytes 20.8% Monocytes 5,5%); red blood cells count (RBC) 3.970000/mmc Haemoglobin (Hb) 13,4 g/dl; hematocrit (HCT) 38.3%; mean corpuscular volume (MCV) 96,4 Platelet count (PLT) 129.000/mmc. On the basis of this clinical presentation and histological findings was excluded a diagnosis of lymphoma with a leukemic presentation. CT (computed tomography) scan showed multiple deep and superficial lymph-nodes enlargement in the neck, thorax and abdomen. Focal hypoechoic lesions were detectable in the spleen. A latero-cervical/submandibular nodal biopsy was performed for diagnosis purpose. The specimen was fixed in 10% neutral buffered formalin and paraffin embedded. Five microns thick sections were stained with hematoxylin and eosin for histological examination (Figure1).

Bottom Line: Peripheral T-cell lymphomas not otherwise specified are generally considered aggressive non-Hodgkin lymphomas, because of poor natural outcome and response to therapy.They show a complex karyotype without any specific genetic hallmark.Several pitfalls could lead to misinterpretation of diagnosis, therefore, we underlined the need to integrate the classical histology and immunohistochemistry with molecular tests as clonality or fluorescence in situ hybridization.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pathology Unit, National Cancer Institute Fondazione Giovanni Pascale, Via Mariano Semmola, 80131 Napoli, Italy.

ABSTRACT

Unlabelled: Peripheral T-cell lymphomas not otherwise specified are generally considered aggressive non-Hodgkin lymphomas, because of poor natural outcome and response to therapy. They show a complex karyotype without any specific genetic hallmark. We report a case of peripheral T-cell lymphoma not otherwise specified with heterogeneous nuclear cyclin D1 immunohistochemical overexpression, due to gene copy gain, a phenomenon similar to that observed in mantle cell lymphoma characterized by t(11;14)(q13;q32). In this case report we underline the diagnostic pitfall represented by cyclin D1 immunohistochemical overexpression in a T-cell lymphoma. Several pitfalls could lead to misinterpretation of diagnosis, therefore, we underlined the need to integrate the classical histology and immunohistochemistry with molecular tests as clonality or fluorescence in situ hybridization.

Virtual slide: The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1117747619703769.

Show MeSH
Related in: MedlinePlus