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A case of enteropathy-associated T-cell lymphoma (type I) arising in stomach without refractory celiac disease.

Wang L, Liu Y, Lin XY, Yu JH, Miao Y, Qiu XS, Wang EH - Diagn Pathol (2012)

Bottom Line: EATL type I is a large cell lymphoma which is more common in frequency and highly associated with celiac disease compared with type II.Histologically, the tumor was composed of polymorphic (pleomorphic, anaplastic, immunoblastic) lymphoid cells and numerous inflammatory cells, including histiocytes, neutrophils and eosinophils in the background.The pleomorphic lymphoid cells were diffuse and strongly positive for CD3 and partially positive for CD30, while negative for CD4, CD5, CD8 or CD56.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang 110001, China. wangeh775@gmail.com

ABSTRACT

Unlabelled: Enteropathy-associated T-cell lymphoma (EATL) is a rare peripheral T-cell lymphoma which was classified into 2 types based on histology. EATL is often, but not always, associated with celiac disease. EATL type I is a large cell lymphoma which is more common in frequency and highly associated with celiac disease compared with type II. Jejunum and ileum are the common sites, although EATL can rarely occur in the duodenum, stomach and colon or outside the gastrointestinal tract. We herein presented one case of gastric EATL, which happened in a 73-year-old Chinese male patient. Histologically, the tumor was composed of polymorphic (pleomorphic, anaplastic, immunoblastic) lymphoid cells and numerous inflammatory cells, including histiocytes, neutrophils and eosinophils in the background. The pleomorphic lymphoid cells were diffuse and strongly positive for CD3 and partially positive for CD30, while negative for CD4, CD5, CD8 or CD56. The gastric EATL should be distinguished from other gastric lesions, such as peptic ulcer, poorly-differentiated adenocarcinoma and other types of lymphoma.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1174320824810970.

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Histological features of this case. A: The tumor formed an ulcerating mucosal mass. B: Intraepithelial lymphocytosis was also seen in the adjacent gastric mucosa. C and D: The ulcer was deep and caused the transmural infiltration by florid mixed inflammatory cells. E and F: Neoplastic lymphoid cells (black arrow) were scattered amidst the inflammatory infiltrate. A large number of neutrophils and eosinophils were also observed (red arrow).
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Figure 1: Histological features of this case. A: The tumor formed an ulcerating mucosal mass. B: Intraepithelial lymphocytosis was also seen in the adjacent gastric mucosa. C and D: The ulcer was deep and caused the transmural infiltration by florid mixed inflammatory cells. E and F: Neoplastic lymphoid cells (black arrow) were scattered amidst the inflammatory infiltrate. A large number of neutrophils and eosinophils were also observed (red arrow).

Mentions: The tumor formed an ulcerating mucosal mass that invades the wall of stomach (Figure1A-F). The ulcer was deep and caused the transmural infiltration by florid mixed inflammatory cells which were also seen in the lamina propria of adjacent non-ulcerated mucosa (Figure1A-D). However, careful scrutiny revealed varying numbers of neoplastic lymphoid cells amidst the inflammatory background. The tumor cells exhibited various cytological appearances with concentrated chromatin. The tumor consisted of medium to large pleomorphic cells with round or angulated nuclei. Nucleoli were barely seen. A large number of histiocytes, neutrophils and eosinophils formed the inflammatory background. In addition, crypt abscesses and atypical hyperplasia of propria glands were also presented in this case (Figure1E-F).


A case of enteropathy-associated T-cell lymphoma (type I) arising in stomach without refractory celiac disease.

Wang L, Liu Y, Lin XY, Yu JH, Miao Y, Qiu XS, Wang EH - Diagn Pathol (2012)

Histological features of this case. A: The tumor formed an ulcerating mucosal mass. B: Intraepithelial lymphocytosis was also seen in the adjacent gastric mucosa. C and D: The ulcer was deep and caused the transmural infiltration by florid mixed inflammatory cells. E and F: Neoplastic lymphoid cells (black arrow) were scattered amidst the inflammatory infiltrate. A large number of neutrophils and eosinophils were also observed (red arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539911&req=5

Figure 1: Histological features of this case. A: The tumor formed an ulcerating mucosal mass. B: Intraepithelial lymphocytosis was also seen in the adjacent gastric mucosa. C and D: The ulcer was deep and caused the transmural infiltration by florid mixed inflammatory cells. E and F: Neoplastic lymphoid cells (black arrow) were scattered amidst the inflammatory infiltrate. A large number of neutrophils and eosinophils were also observed (red arrow).
Mentions: The tumor formed an ulcerating mucosal mass that invades the wall of stomach (Figure1A-F). The ulcer was deep and caused the transmural infiltration by florid mixed inflammatory cells which were also seen in the lamina propria of adjacent non-ulcerated mucosa (Figure1A-D). However, careful scrutiny revealed varying numbers of neoplastic lymphoid cells amidst the inflammatory background. The tumor cells exhibited various cytological appearances with concentrated chromatin. The tumor consisted of medium to large pleomorphic cells with round or angulated nuclei. Nucleoli were barely seen. A large number of histiocytes, neutrophils and eosinophils formed the inflammatory background. In addition, crypt abscesses and atypical hyperplasia of propria glands were also presented in this case (Figure1E-F).

Bottom Line: EATL type I is a large cell lymphoma which is more common in frequency and highly associated with celiac disease compared with type II.Histologically, the tumor was composed of polymorphic (pleomorphic, anaplastic, immunoblastic) lymphoid cells and numerous inflammatory cells, including histiocytes, neutrophils and eosinophils in the background.The pleomorphic lymphoid cells were diffuse and strongly positive for CD3 and partially positive for CD30, while negative for CD4, CD5, CD8 or CD56.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang 110001, China. wangeh775@gmail.com

ABSTRACT

Unlabelled: Enteropathy-associated T-cell lymphoma (EATL) is a rare peripheral T-cell lymphoma which was classified into 2 types based on histology. EATL is often, but not always, associated with celiac disease. EATL type I is a large cell lymphoma which is more common in frequency and highly associated with celiac disease compared with type II. Jejunum and ileum are the common sites, although EATL can rarely occur in the duodenum, stomach and colon or outside the gastrointestinal tract. We herein presented one case of gastric EATL, which happened in a 73-year-old Chinese male patient. Histologically, the tumor was composed of polymorphic (pleomorphic, anaplastic, immunoblastic) lymphoid cells and numerous inflammatory cells, including histiocytes, neutrophils and eosinophils in the background. The pleomorphic lymphoid cells were diffuse and strongly positive for CD3 and partially positive for CD30, while negative for CD4, CD5, CD8 or CD56. The gastric EATL should be distinguished from other gastric lesions, such as peptic ulcer, poorly-differentiated adenocarcinoma and other types of lymphoma.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1174320824810970.

Show MeSH
Related in: MedlinePlus