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Original Article
Clinicopathological implications of immunohistochemical expression of TBX21, CXCR3, GATA3, CCR4, and TCF1 in nodal follicular helper T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified
Bogyeong Han, Sojung Lim, Jeemin Yim, Young Keun Song, Jiwon Koh, Sehui Kim, Cheol Lee, Young A Kim, Yoon Kyung Jeon
J Pathol Transl Med. 2024;58(2):59-71.   Published online January 22, 2024
DOI: https://doi.org/10.4132/jptm.2024.01.04
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AbstractAbstract PDFSupplementary Material
Background
The classification of nodal peripheral T-cell lymphoma (PTCL) has evolved according to histology, cell-of-origin, and genetic alterations. However, the comprehensive expression pattern of follicular helper T-cell (Tfh) markers, T-cell factor-1 (TCF1), and Th1- and Th2-like molecules in nodal PTCL is unclear.
Methods
Eighty-two cases of nodal PTCL were classified into 53 angioimmunoblastic T-cell lymphomas (AITLs)/nodal T-follicular helper cell lymphoma (nTFHL)-AI, 18 PTCLs-Tfh/nTFHL–not otherwise specified (NOS), and 11 PTCLs-NOS according to the revised 4th/5th World Health Organization classifications. Immunohistochemistry for TCF1, TBX21, CXCR3, GATA3, and CCR4 was performed.
Results
TCF1 was highly expressed in up to 68% of patients with nTFHL but also in 44% of patients with PTCL-NOS (p > .05). CXCR3 expression was higher in AITLs than in non-AITLs (p = .035), whereas GATA3 expression was higher in non-AITL than in AITL (p = .007) and in PTCL-Tfh compared to AITL (p = .010). Of the cases, 70% of AITL, 44% of PTCLTfh/ nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the TBX21 subtype; and 15% of AITL, 38% of PTCL-Tfh/nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the GATA3 subtype. The others were an unclassified subtype. CCR4 expression was associated with poor progression-free survival (PFS) in patients with PTCL-Tfh (p < .001) and nTFHL (p = .023). The GATA3 subtype showed poor overall survival in PTCL-NOS compared to TBX21 (p = .046) and tended to be associated with poor PFS in patients with non-AITL (p = .054).
Conclusions
The TBX21 subtype was more prevalent than the GATA3 subtype in AITL. The GATA3 subtype was associated with poor prognosis in patients with non-AITL and PTCL-NOS.
Case Studies
Intravascular NK/T-cell lymphoma: a case report and literature review
Ji Min Na, Wookjae Jung, Minhye Kim, Yun-Hong Cheon, Jong Sil Lee, Dae Hyun Song, Jung Wook Yang
J Pathol Transl Med. 2023;57(6):332-336.   Published online November 14, 2023
DOI: https://doi.org/10.4132/jptm.2023.10.30
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  • 170 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Intravascular lymphoma is characterized by an exclusively intravascular distribution of tumor cells. Intravascular natural killer/T-cell lymphoma (IVNKTL) is extremely rare, highly aggressive, commonly Epstein-Barr virus (EBV)–positive, and predominantly affects the skin and central nervous system. Here we report a case of IVNKTL diagnosed in a 67-year-old female, presenting with persistent intermittent fever and skin rashes throughout the body. Incisional biopsy of an erythematous lesion on the chest exhibited aggregation of medium to large-sized atypical lymphoid cells confined to the lumen of small vessels that were positive for CD3, granzyme B, and CD56 on immunohistochemistry and EBV-encoded RNA in situ hybridization. EBV DNA was also detected in serum after diagnosis. With a review of 26 cases of IVNKTL to date, we suggest that active biopsy based on EBV DNA detection may facilitate early diagnosis of IVNKTL.

Citations

Citations to this article as recorded by  
  • Cutaneous Intravascular Hematolymphoid Entities: A Review
    Emily Hatheway Marshall, Bethany Brumbaugh, Allison Holt, Steven T. Chen, Mai P. Hoang
    Diagnostics.2024; 14(7): 679.     CrossRef
Unsuspected systemic Epstein-Barr virus–positive T-cell lymphoma of childhood diagnosed at autopsy in a potential homicide case
Daniel J. Robbins, Erik A. Ranheim, Jamie E. Kallan
J Pathol Transl Med. 2023;57(2):123-127.   Published online December 22, 2022
DOI: https://doi.org/10.4132/jptm.2022.10.31
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AbstractAbstract PDF
Systemic Epstein-Barr virus (EBV)–positive T-cell lymphoma of childhood (SETLC) is a rare, rapidly progressive, and often fatal disease of children and young adults characterized by monoclonal expansion of EBV-positive T cells in tissues or peripheral blood following infection with EBV. Its distinction from other EBV-positive T-cell lymphoproliferative disorders with overlapping features can be difficult, and particular diagnostic features may not be manifest until autopsy examination. We present the case of a 10-year-old boy with significant disability due to remote traumatic brain injury following non-accidental head trauma who died unexpectedly at home. Given the history of physical abuse and the potential for homicide charges, significant medicolegal implications arose with this case. Pathologic investigation ultimately revealed conclusive diagnostic features of SETLC including extensive proliferation of EBV-positive T cells in multiple organs. A natural manner of death was confirmed, thereby excluding delayed homicide related to complications of non-accidental head trauma.
Primary Peripheral Gamma Delta T-Cell Lymphoma of the Central Nervous System: Report of a Case Involving the Intramedullary Spinal Cord and Presenting with Myelopathy
Jeemin Yim, Seung Geun Song, Sehui Kim, Jae Won Choi, Kyu-Chong Lee, Jeong Mo Bae, Yoon Kyung Jeon
J Pathol Transl Med. 2019;53(1):57-61.   Published online October 1, 2018
DOI: https://doi.org/10.4132/jptm.2018.08.21
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  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Primary central nervous system lymphoma of T-cell origin (T-PCNSL) is rare, and its clinicopathological features remain unclear. Peripheral T-cell lymphoma of γδ T-cell origin is an aggressive lymphoma mainly involving extranodal sites. Here, we report a case of γδ T-PCNSL involving the intramedullary spinal cord and presenting with paraplegia. A 75-year-old Korean woman visited the hospital complaining of back pain and lower extremity weakness. Magnetic resonance imaging revealed multifocal enhancing intramedullary nodular lesions in the thoracic and lumbar spinal cord. An enhancing nodular lesion was observed in the periventricular white matter of the lateral ventricle in the brain. There were no other abnormalities in systemic organs or skin. Laminectomy and tumor removal were performed. The tumor consisted of monomorphic, medium-to-large atypical lymphocytes with pale-to-eosinophilic cytoplasm. Immunohistochemically, the tumor cells were CD3(+), TCRβF1(-), TCRγ(+), CD30(-), CD4(-), CD8(-), CD56(+), TIA1(+), granzyme B(+), and CD103(+). Epstein-Barr virus in situ was negative. This case represents a unique T-PCNSL of γδ T-cell origin involving the spinal cord.

Citations

Citations to this article as recorded by  
  • B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review
    Daniel Gregório Gonsalves, Paulo Eduardo Albuquerque Zito Raffa, Gabriela Gerenutti de Sousa, Melissa Esposito Gomes Rigueiral, Iracema Araújo Estevão, Cesar Cozar Pacheco, Roger Thomaz Rotta Medeiros, Paulo Roberto Franceschini, Paulo Henrique Pires de A
    Asian Journal of Neurosurgery.2023; 18(02): 231.     CrossRef
  • Primary intramedullary spinal cord lymphoma misdiagnosed as longitudinally extensive transverse myelitis: a case report and literature review
    Huizhen Ge, Li Xu, Huajie Gao, Suqiong Ji
    BMC Neurology.2023;[Epub]     CrossRef
  • Clinicopathologic and Genetic Features of Primary T-cell Lymphomas of the Central Nervous System
    Jeemin Yim, Jiwon Koh, Sehui Kim, Seung Geun Song, Jeong Mo Bae, Hongseok Yun, Ji-Youn Sung, Tae Min Kim, Sung-Hye Park, Yoon Kyung Jeon
    American Journal of Surgical Pathology.2022; 46(4): 486.     CrossRef
  • Peripheral T-Cell Lymphomas Involving the Central Nervous System: A Report From the Czech Lymphoma Study Group Registry
    Heidi Mocikova, Robert Pytlík, Katerina Benesova, Andrea Janikova, Juraj Duras, Alice Sykorova, Katerina Steinerova, Vit Prochazka, Vit Campr, David Belada, Marek Trneny
    Frontiers in Oncology.2022;[Epub]     CrossRef
Original Articles
Upregulated Neuro-oncological Ventral Antigen 1 (NOVA1) Expression Is Specific to Mature and Immature T- and NK-Cell Lymphomas
Eun Kyung Kim, Sun Och Yoon, Soo Hee Kim, Woo Ick Yang, Yoon Ah Cho, Soo Jeong Kim
J Pathol Transl Med. 2016;50(2):104-112.   Published online February 29, 2016
DOI: https://doi.org/10.4132/jptm.2016.02.08
  • 8,811 View
  • 68 Download
  • 14 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Background
Recent studies have revealed that the splicing factor neuro-oncological ventral antigen 1 (NOVA1) is enriched in fibroblasts and accumulated T cells of tertiary lymphoid structures. In the present study, we investigated NOVA1 expression in various subtypes of mature and immature T- and natural killer (NK)-cell lymphomas as well as in various B-cell lymphoma subtypes. Methods: NOVA1 immunoexpression was evaluated in hyperplastic palatine tonsils (n = 20), T- and NK-cell lymphomas (n = 177), diffuse large B-cell lymphomas (n = 151), and other types of B cell lymphomas (n = 31). Nuclear staining intensity and percentage of positive tumor cells were graded. NOVA1 mRNA expression was analyzed in various lymphoma cell lines. Results: Tumor cells of T- and NK-cell lymphomas showed higher expression levels of NOVA1 than did normal paracortical T cells, and 56.5% of T- and NK-cell lymphoma cases showed diffuse and strong expression. The NOVA1 expression level varied according to the subtype; it was higher in angioimmunoblastic T-cell lymphoma, anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL), and T lymphoblastic leukemia/lymphoma (T-LBL), but it was lower in ALK-positive ALCL. In almost all B-cell lymphomas, NOVA1 expression was very low or negative. NOVA1 mRNA was also expressed in Jurkat, a T-LBL cell line. Conclusions: The present findings suggest that NOVA1 upregulation may be involved in certain subtypes of T- and NK-cell lymphomas, but not in B-cell lymphomas. Upregulated NOVA1 expression seems to be a specific biological feature of activated T cells such as T- and NK-cell lymphomas.

Citations

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    Aslı Kahraman, Fikret Dirilenoğlu, İsmail Güzeliş, Kenan Çetinoğlu
    Annals of Diagnostic Pathology.2024; 69: 152246.     CrossRef
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    Yoko Tajima, Keiichi Ito, Yuan Yuan, Mayu O. Frank, Yuhki Saito, Robert B. Darnell
    Cell Reports.2023; 42(2): 112050.     CrossRef
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    Dongyun Li, Mingzhi Shen, Xinxin Deng, Yongyi Bai
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    BMC Cancer.2022;[Epub]     CrossRef
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    Scientific Reports.2019;[Epub]     CrossRef
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    Surgical Oncology.2019; 31: 67.     CrossRef
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    Xin Yu, Heyi Zheng, Matthew T.V. Chan, William K.K. Wu
    Journal of Cellular and Molecular Medicine.2018; 22(5): 2622.     CrossRef
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    Cell Proliferation.2017;[Epub]     CrossRef
  • New developments in the pathology of malignant lymphoma. A review of the literature published from January–April 2016
    J. Han van Krieken
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EBV-Positive T/NK-Cell Lymphoproliferative Disease of Childhood
Mineui Hong, Young Hyeh Ko, Keon Hee Yoo, Hong Hoe Koo, Seok Jin Kim, Won Seog Kim, Heejung Park
Korean J Pathol. 2013;47(2):137-147.   Published online April 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.137
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  • 110 Download
  • 25 Crossref
AbstractAbstract PDF
Background

Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH), EBV-positive systemic T-cell lymphoproliferative disease (STLPD) of childhood, and chronic active EBV (CAEBV) infection may develop after primary EBV infection. This study reviewed the clinicopathological spectrum of EBV-associated T- and natural killer (NK)-cell LPD, including STLPD and CAEBV infection, with an analysis of T-cell clonality.

Methods

Clinicopathological features of seven patients with EBV-associated HLH or STLPD and 12 patients with CAEBV infection were reviewed. Immunohistochemical staining and a T-cell receptor (TCR) gene rearrangement study were performed.

Results

STLPD and EBV-positive HLH showed significantly overlapping clinicopathological findings. One patient with STLPD and one patient with EBV-positive HLH demonstrated moderate to severe atypia of the infiltrating lymphocytes, whereas the remaining patients lacked significant atypia. Twelve patients had CAEBV infection, four of whom suffered mosquito-bite hypersensitivity, five showed NK lymphocytosis, and one suffered hydroa vacciniforme. Infiltrating lymphocytes were predominantly small and devoid of atypia. Hemophagocytic histiocytosis was found in seven of 11 patients. Monoclonality was detected in three (50%) of the six patients with successful TCR gene analysis.

Conclusions

EBV-positive HLH and STLPD share similar clinicopathological findings and may constitute a continuous spectrum of acute EBV-associated T- or NK-cell proliferative disorders. The distinction of EBV-positive T-cell LPD from EBV-positive HLH may be difficult during routine diagnoses because of the technical limitations of clonality assessment.

Citations

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    Yang Shen, Yu Fang Wang
    Journal of Digestive Diseases.2022; 23(5-6): 248.     CrossRef
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    Young Hyeh Ko
    Clinical Pediatric Hematology-Oncology.2021; 28(1): 14.     CrossRef
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Case Report
Touch Imprint and Fine Needle Aspiration Cytology of Giant Cell Tumor of Tendon Sheath: A Case Report.
Jong Im Lee
Korean J Cytopathol. 2008;19(1):57-64.
DOI: https://doi.org/10.3338/kjc.2008.19.1.57
  • 2,230 View
  • 15 Download
AbstractAbstract PDF
Giant cell tumor of the tendon sheath (GCTTS) is a slowly growing, benign soft tissue tumor. The tumors occur predominantly on the hands and feet. Although the clinical and histopathologic features are well-defined, only a few reports have described the cytologic appearance of this entity. A 26-year-old woman presented with a gradually developing circumscribed soft tissue mass near the proximal phalanx of her left little finger for one year. Imprint and fine needle aspiration (FNA) smears were obtained from the excisional biopsy specimen. The imprint smears were composed of predominantly singly dispersed bland mononuclear cells and several giant cells. The mononuclear cells were polygonal to round, and they showed a histiocyte-like appearance. Osteoclast-type multinucleated giant cells of various sizes were randomly scattered throughout the smears, and these cells contained 3 to 50 nuclei. Nuclear atypia and pleomorphism were absent in both the single and giant cells. Loose aggregates of hemosiderin-laden macrophages and binuclear stromal cells were also seen. The cytologic features of the FNA smears were similar with those of the imprint. Additionally, the FNA smears contained several clumps of densely collagenous stromal tissue that were seldom noted in previously reported cytologic material. The cytologic features were well-correlated with the concurrent histologic findings and the diagnosis of GCTTS was made. When the clinical and radiologic datas are integrated, the diagnosis of GCTTS can be strongly suggested, based on the pre-operative cytologic specimen.
Original Articles
Non-Radioactive Detection of Clonality in Malignant Lymphoid Neoplasms using the Polymerase Chain Reaction.
Chan Kum Park, Chul Woo Kim
Korean J Pathol. 1996;30(4):311-317.
  • 1,387 View
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AbstractAbstract PDF
The polymerase chain reaction(PCR) was performed to detect clonal rearrangements of the immunoglobulin heavy chain gene(IgH) or T-cell receptor(TCR) genes in 57 lymphoproliferative diseases including 26 B-cell lymphomas and 23 peripheral T-cell lymphomas(PTCL). Using the IgH primers, monoclonality was detected in 19 out of 22(86.4%) cases of diffuse lymphomas and 2 out of 4(50%) follicular lymphomas, respectively, but not in the 23 PTCL cases. Using the V and J regions of the TCRgamma chain primers, monoclonality was detected in 14 out of the 23(60.9%) PTCL cases. TCR beta chain gene rearrangements were observed in 7 out of the 9 cases which did not show TCRgamma chain gene rearrangements. One non-T non-B acute lymphoblastic leukemia was found to have TCR beta chain gene rearrangements. In conclusion, analysis of Ig and TCR gene rearrangements by using the PCR technique can be used as a useful diagnostic adjunct to establish the clonality of various lymphoproliferative diseases.
EBV in Situ Hybridization Study for Cutaneous T-Cell Lymphomas.
Chan Kum Park, Chang Woo Lee, Jung Dal Lee
Korean J Pathol. 1996;30(8):699-705.
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AbstractAbstract PDF
We studied 24 cases of cutaneous T-cell lymphomas and six cases of benign lymphoproliferative diseases of the skin (2 Jessner's lymphocytic infiltration, 2 pseudolymphoma, 2 lymphomatoid papulosis) for the presence of Epstein-Barr Virus(EBV) RNA, using the in situ hybridization(ISH) method. Among the 24 cases of cutaneous T-cell lymphomas (CTCL), 18 cases including 12 cases of mycosis fungoides(MF) were primary CTCL, and the other 6 cases were secondary CTCL. The ISH study demonstrated a positive reaction for EBER probe in 6 out of the 24 cases(25%) of CTCL, and a negative reaction for BHLF nuclear RNA probe in all the cases studied. Double-labelling immunohistochemistry/ISH studies revealed that the EBV positive cells were CD45RO positive and CD20 negative. EBV genome was not demonstrated in any benign lymphoproliferative diseases of the skin. Among the EBER positive cases, none of the 12 cases of MF demonstrated EBER signals, and 6 out of the 12(50%) cases of CTCL were positive for EBER probe. In conclusion, latent infection of EBV may play a role in the development of non-mycosis fungoides T-cell lymphomas involving the skin.
Molecular Diagnosis of Cutaneous T Cell Lymphoproliferative Diseases.
Ji Young Park, Myung Hoon Lee, Eun Kyung Kwak, Dong Ja Kim, Tae In Park, Han Ik Bae
Korean J Pathol. 2000;34(11):941-949.
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AbstractAbstract PDF
It is often problematic to diagnose T-cell lymphoproliferative disorders of the skin because of the difficulty in establishing clonality in paraffin-embedded tissue. We used polymerase chain reaction single strand conformational polymorphism (PCR-SSCP) and heteroduplex analysis in paraffin embedded tissue to detect clonal rearrangement of T-cell receptor gamma (TCRgamma) gene in 17 T-cell lymphoproliferative disorders and 6 atypical lymphoproliferative diseases. We used polymerase chain reaction to detect TCR beta gene rearrangement in 8 of 17 cases which did not show TCRgamma gene rearrangement. Jurkat cell lines were used as monoclonal controls. DNA was extracted from 5 biopsies of T-cell lymphomas, 10 biopsies of mycosis fungoides, 2 biopsies of lymphomatoid papulosis, and 6 biopsies of atypical lymphoproliferative lesions. We detected monoclonality in 5 of 5 T-cell lymphoma cases, 2 of 2 lymphomatoid papulosis cases, 6 of 10 mycosis fungoides cases, and 2 of 6 atypical lymphoproliferative disease cases. We conclude that nonradioactive PCR-SSCP for TCR gene rearrangement analysis is a useful adjunct to routine histological and immunophenotypic methods in the diagnosis of cutaneous T cell lymphoproliferative disorders in paraffin embedded tissue.
Case Reports
Fine Needle Aspiration Cytological Findings of Angioimmunoblastic T-cell Lymphoma : A Brief Case Report.
Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Chang Suk Kang, Kyo Young Lee
Korean J Cytopathol. 2006;17(2):159-161.
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AbstractAbstract PDF
Recently, we experienced a case of Angioimmunoblastic T-cell lymphom (AITL) in a 60-year-old man presented with lymphadenopathy, which is first cytological report in Korea. The cytological features showed a heterogeneous population of small to medium-sized lymphocytes, immunoblasts, and plasma cells. Characteristically, there were also a distinct population of follicular dendritic cells admixed with lymphoid cells, forming the so-called dendritic cell-lymphocyte complexes. Histological features showed the classic morphologic features of AITL. Recognition of the characteristic cytological features can suggest the possibility of AITL.
Ki-1 Positive Extranodal NK/T Cell Lymphoma, Nasal Type, Mistaken as Dermatomyositis: A Case Report and Literature Review.
Hyun Jung Kim, Eunah Shin, Jung Yeon Kim, Kyeongmee Park, Young Jin Yoo, Seung Sook Lee
Korean J Pathol. 2007;41(4):278-283.
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AbstractAbstract PDF
We report a case of a 38-year-old male with extranodal NK/T-cell lymphoma, nasal type, showing unusual clinical and pathological features. The patient was admitted for soft tissue swelling and tenderness in both legs. The patient had been treated intermittently 8 months prior for repeated muco-cutaneous ulcers. A muscle biopsy showed medium-sized atypical lymphoid cells with bizarre nuclei and plump cytoplasm, infiltrating to the skeletal muscle fibers with angiocentricity. The immunoresults were Ki-1+, CD56+, cytoplasmic CD3+, with EBV-in situ hybridization +. The patient rapidly deteriorated and died of sepsis and respiratory failure shortly after initiation of low-dose chemotherapy. A careful review of previous biopsies revealed scarce atypical lymphoid cells around vessels with similar immunoprofiles without the presence of Ki-1 positive cells. This case emphasizes that an extranodal NK/T-cell lymphoma may have a dermatomyositis-like diffuse presentation. Ki-1 co-expression can be an unexpected event in a process of the disease course; however, this should be validated with future studies.
A Case of Intestinal Anthrax with Recovery after Surgical Intervention .
Jong Im Lee, Jung Ran Kim, Dong Hoon Kim, Byoung Ook Jeoung
Korean J Pathol. 1995;29(2):268-271.
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Anthrax in man is usually cutaneous, resulting from contact with materials derived from infected livestock. Internal organs are infrequently involved,. This report concerns a case of primary anthrax of intestine. The first case of primary anthrax of intestine is to our knowledge in Korea. The patient was a 14-year-old male who has complained of nausea, vomiting and acute abdominal pain. History was otherwise noncontributory except for ingestion raw meat of the dead cattle, one day before the onset of the disease. The cattle presumably died due to Bacillus anthracis in a village Bae-Ban Dong in the city of Kyung ju, Kyung Pook. Among 15 sufferers, 2 cases died 3 days later. Bacillus anthracis isolated from the raw beef, blood samples of two patients and throat culture of one patient. At laparotomy, the peritoneal cavity was full of serosanginous fluid. Right hemicolectomy including partial resection of ileum was done. The bowel was segmentally dilated, hemorrhagic and necrotic, especially at terminal ileum. The mucosa was edematous and largely ulcerated covered with greenish yellow exudate. The intense vascular congestion with hemorrhage and numerous colonization of bacteria were present through the entire wall. The organisms were large, gram-positive and PAS-negative bacilli in long chain. Bacterial emboli were scattered in lymphatics. The other feature was band like lymphoid cell infiltration in ulcer base and submucosal layer. Payer's patches were prominent and the germinal centers were necrotic. Interfollicular spaces exhibited aggregates of numerous atypical lymphoid cells. The cells were five times larger than resting lymphocytes and had several prominent nucleoli and abundant amphophilic cytoplasm. On immunohistochemical staining, most of atypical cells were positive for T-cell marker and Ki-I Ag. The mesenteric lymph nodes were enlarged, showing reactive feature, and the atypical cells were also demonstrated. The patient recovered completely.
Nesal T-cell Lymphoma associated with Hemophagocytic Syndrome: A case report.
Mee Sook Roh, Jin Sook Jeong, Sook Hee Hong
Korean J Pathol. 1994;28(5):541-543.
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Peripheral T-cell lymphoma is the generic group given to a family of tumors composed of neoplastic lymphocytes with phenotypic features of peripheral T-cells. Certain peripheral T-cell lymphomas develop a hemophagocytic syndrome that mimics malignant histiocytosis, both clinically and pathologically. We experienced a case of nasal T-cell lymphoma, histologically mimicking malignant histiocytosis in a 40-year-old male. The chief complaints were nasal obstruction and intermittent mild fever. Mild anemia, elevated SGOT and SGPT, polyclonal gammophthy, and moderate hepatomegaly were present. Two weeks later was present an enlarged cervical lymph node. The biopsied nasal mass showed angiocentric and angiodestructive peripheral T-cell lymphoma withextensive necrosis and marked erythrophagocytosis by non-neoplastic histiocytes. Subsequently, cervical lymph node was biopsied, which showed peripheral T-cell ltmphoma with extensive necrosis and erythrophagocytosis as well. The atypical lymphoid cells revealed pan-T(+), but CD4(-) and CD8(-), whereas the reactive histiocytes showed lysozyme(+), immunohistochemistry.
Original Article
Immunohistochemical Study of Upper Respiratory Tract Malignant Lymphomas with Features of Polymorphic Reticulosis.
Jeong Ja Park, Tae In Park, Young Hyeh Ko, Jung Dal Lee
Korean J Pathol. 1994;28(2):144-148.
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Malignant lymphomas of the upper respiratory tract are relatively common in the Orient including Korea. They have a marked clinicopathologic and immunophenotypic diversity. We retrospectively reviewed 20 cases of malignant lymphomas with features of polymorphic reticulosis in the upper respiratory tract. Histopathologic findings consisted of polymorphism of lymphoid cells in 17 cases(85%), angiocentricity in 14 cases(70%), coagulation necrosis in 12 cases(60%), and epitheliotropism in 8 cases(40%). By Working Formulation, 14 cases(70%) were classified as diffuse large cell type, 4 cases(20%) as diffuse mixed small cleaved and large cell type, one case as immunoblastic type, and one case as anaplastic large cell type. On immunostaining, one showed B-cell phenotype and 19 cases showed T-cell phenotype. The B-cell type was histologically diffuse large cell type. From these results, we concluded that polymorphic reticulosis is a type of peripheral T-cell lymphoma with angiocentricity.

J Pathol Transl Med : Journal of Pathology and Translational Medicine