RESUMO
Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) consists of a heterogeneous group of lymphomas. Patients generally show an aggressive clinical course and very poor outcome. Although the 2008 World Health Organization classification of PTCL-NOS includes 3 variants, low-grade lymphoma is not included. Of 277 PTCL-NOS cases recorded in our consultation files, we examined the clinicopathologic characteristics of 10 patients with T-cell lymphomas composed of small-sized cells with slight nuclear atypia. Eight patients showed extranodal involvement (5 patients, spleen; 3 patients, thyroid), and 5 patients were at clinical stage I or II. Histologically, all samples presented diffuse infiltrate of small lymphoid cells, with few mitotic figures. Immunohistologically, all samples were positive for CD3, and CD20 was detected in 5 samples. All samples showed a low Ki-67 labeling index (mean, 1.05%), and 7 samples were positive for central memory T-cell markers. Clonal T-cell receptor γ chain and/or α-ß chain gene rearrangements were detected in all 10 patients. Five patients received chemotherapy, whereas for 3 patients, treatment consisted only of observation following surgical resection of the spleen or thyroid. Nine patients were alive at a median follow-up time of 19.5 months, whereas 1 patient died of an unrelated disease. The present study strongly indicates that T-cell lymphoma with small-sized lymphoma cells and a low Ki-67 labeling index is a distinct variant. Recognition of this novel lymphoma subtype, which should not be defined merely as PTCL-NOS, should be seriously considered.
Assuntos
Linfoma de Células T Periférico/patologia , Neoplasias Esplênicas/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Núcleo Celular/patologia , Proliferação de Células , Quimioterapia Adjuvante , Células Clonais , Feminino , Rearranjo Gênico da Cadeia alfa dos Receptores de Antígenos dos Linfócitos T/genética , Rearranjo Gênico da Cadeia beta dos Receptores de Antígenos dos Linfócitos T/genética , Rearranjo Gênico da Cadeia gama dos Receptores de Antígenos dos Linfócitos T/genética , Humanos , Antígeno Ki-67/metabolismo , Linfoma de Células T Periférico/genética , Linfoma de Células T Periférico/metabolismo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Esplênicas/genética , Neoplasias Esplênicas/metabolismo , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/metabolismoRESUMO
A 61-year-old woman was referred to our hospital with a mass in the left proglossis. The lesion was excised with a provisional diagnosis of hemangioma. The mass was well-demarcated and easily dissected with an ultrasonic surgical aspirator. The histopathologic diagnosis was angiomyolipoma arising in the tongue. There were no signs of recurrence at followup at 18 months.
RESUMO
An 82-year-old man was diagnosed with lymphoplasmacytic lymphoma involving multiple lymph nodes and bone marrow. On radiological examinations no involvement of the lung was seen. He was treated with rituximab. Eighteen months later he was complicated with right pneumothorax, and surgery with bullectomy was finally performed. Histological examination disclosed the proliferation of abnormal B lymphocytes near the wall of the bulla and pleura. We conclude that the pneumothorax in this patient was associated with lymphoma. Thus, radiological examination does not disclose lymphomatous lesions, it is possible that lymphoma involves the pleura, and pleural involvement can cause pneumothorax. Surgery is an effective method of treating this rare complication.