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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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Immunohistochemical staining. A: The epithelium of gland was positive staining for AE1/AE3. B-D: The tumor cells were negative staining for CD5, CD8 and CD56. E: The tumor cells were strongly diffuse positive staining for CD3. F: The tumor cells partially expressed CD30. G and H: CD20 and Pax-5 labeled the scattered B cells amidst the inflammatory infiltrate. I: The histiocytes among the inflammatory infiltrate were positive for CD68. M and N: CD31 and CD34 underlined the rich vascular channels, whereas the histiocytoid cells were negative. J: Ki67 index was about 20%. K and L: The intraepithelial lymphocytes in the adjacent mucosa were positive for CD3 and CD30.
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Figure 2: Immunohistochemical staining. A: The epithelium of gland was positive staining for AE1/AE3. B-D: The tumor cells were negative staining for CD5, CD8 and CD56. E: The tumor cells were strongly diffuse positive staining for CD3. F: The tumor cells partially expressed CD30. G and H: CD20 and Pax-5 labeled the scattered B cells amidst the inflammatory infiltrate. I: The histiocytes among the inflammatory infiltrate were positive for CD68. M and N: CD31 and CD34 underlined the rich vascular channels, whereas the histiocytoid cells were negative. J: Ki67 index was about 20%. K and L: The intraepithelial lymphocytes in the adjacent mucosa were positive for CD3 and CD30.

Mentions: The immunohistochemical study showed that the pleomorphic lymphoid cells were negative for AE1/AE3, CD5, CD8, CD56 (Figure2A-D) and CD4, strongly positive for CD3 (Figure2E). The tumor cells were partially positive for CD30 (Figure2F). CD20 and Pax-5 labeled the scattered B cells amidst the inflammatory background (Figure2G and H). The histiocytes were labeled by CD68 (Figure2I). Ki67 index was about 20% (Figure2J). The intraepithelial lymphocytes in the adjacent mucosa shared the identical immunophenotype with the pleomorphic tumor cells (Figure2K and L). In addition, the EBER in situ hybridization stain for EBV was negative. The results were listed in Table1.


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)

Immunohistochemical staining. A: The epithelium of gland was positive staining for AE1/AE3. B-D: The tumor cells were negative staining for CD5, CD8 and CD56. E: The tumor cells were strongly diffuse positive staining for CD3. F: The tumor cells partially expressed CD30. G and H: CD20 and Pax-5 labeled the scattered B cells amidst the inflammatory infiltrate. I: The histiocytes among the inflammatory infiltrate were positive for CD68. M and N: CD31 and CD34 underlined the rich vascular channels, whereas the histiocytoid cells were negative. J: Ki67 index was about 20%. K and L: The intraepithelial lymphocytes in the adjacent mucosa were positive for CD3 and CD30.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Immunohistochemical staining. A: The epithelium of gland was positive staining for AE1/AE3. B-D: The tumor cells were negative staining for CD5, CD8 and CD56. E: The tumor cells were strongly diffuse positive staining for CD3. F: The tumor cells partially expressed CD30. G and H: CD20 and Pax-5 labeled the scattered B cells amidst the inflammatory infiltrate. I: The histiocytes among the inflammatory infiltrate were positive for CD68. M and N: CD31 and CD34 underlined the rich vascular channels, whereas the histiocytoid cells were negative. J: Ki67 index was about 20%. K and L: The intraepithelial lymphocytes in the adjacent mucosa were positive for CD3 and CD30.
Mentions: The immunohistochemical study showed that the pleomorphic lymphoid cells were negative for AE1/AE3, CD5, CD8, CD56 (Figure2A-D) and CD4, strongly positive for CD3 (Figure2E). The tumor cells were partially positive for CD30 (Figure2F). CD20 and Pax-5 labeled the scattered B cells amidst the inflammatory background (Figure2G and H). The histiocytes were labeled by CD68 (Figure2I). Ki67 index was about 20% (Figure2J). The intraepithelial lymphocytes in the adjacent mucosa shared the identical immunophenotype with the pleomorphic tumor cells (Figure2K and L). In addition, the EBER in situ hybridization stain for EBV was negative. The results were listed in Table1.

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