Peripheral T-cell Lymphomas of Follicular T-Helper Cell Derivation With Hodgkin/Reed-Sternberg Cells of B-cell Lineage
- 1 June 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Surgical Pathology
- Vol. 37 (6), 816-826
- https://doi.org/10.1097/pas.0b013e3182785610
Abstract
Peripheral T-cell lymphomas (PTCLs) are functionally and morphologically complex. Epstein-Barr virus (EBV)-positive B cells have been reported in angioimmunoblastic T-cell lymphoma (AITL) and other PTCLs and may mimic Hodgkin/Reed-Sternberg (HRS) cells, but EBV-negative HRS-like B cells have not been described. We wished to assess the nature of the PTCL associated with HRS-like cells and to determine whether EBV-negative HRS-like cells may be seen. We identified 57 PTCL cases reported as containing HRS-like cells. These included 32 AITL, 19 PTCL, not otherwise specified (NOS), 3 PTCL-NOS, follicular variant, 1 PTCL-NOS, T-zone variant, and 2 adult T-cell leukemia/lymphoma cases. All patients were adults with a median age of 63 and presented with lymphadenopathy. The male:female ratio was 31:26 (1.2:1). Clonal TRG rearrangement was detected in 46/53 cases. Six of 38 cases had a concomitant clonal immunoglobulin gene rearrangement. In 52/57 cases the HRS cells were positive for EBV. Five cases, 3 classified as AITL and 2 as PTCL-NOS, follicular variant, contained HRS-like cells negative for EBV. All PTCLs with EBV-negative HRS cells had a T follicular helper cell immunophenotype. The neoplastic T cells expressed CD3, CD4, and PD-1 and formed rosettes around the HRS-like cells. The HRS-like cells were positive for CD20 (variable intensity), PAX5, CD30, and CD15 (4/5). We conclude that both EBV-positive and EBV-negative HRS-like B cells may occur in the background of PTCL; caution is needed to avoid misdiagnosis as classical Hodgkin lymphoma. The close interaction between the HRS-like cells and the rosetting PD-1-positive T cells suggests a possible pathogenetic role in this phenomenon and provides new insights into the abnormal B-cell proliferations that occur in the context of TFH malignancies.Keywords
This publication has 39 references indexed in Scilit:
- The origins, function, and regulation of T follicular helper cellsThe Journal of Experimental Medicine, 2012
- Nodal Involvement by Cutaneous CD30-positive T-cell Lymphoma Mimicking Classical Hodgkin LymphomaThe American Journal of Surgical Pathology, 2012
- Constitutive AP-1 Activity and EBV Infection Induce PD-L1 in Hodgkin Lymphomas and Posttransplant Lymphoproliferative Disorders: Implications for Targeted TherapyClinical Cancer Research, 2012
- Targeting the PD-1/B7-H1(PD-L1) pathway to activate anti-tumor immunityCurrent Opinion in Immunology, 2012
- Adult T-cell leukemia/lymphoma with Epstein-Barr virus–positive Hodgkin-like cellsHuman Pathology, 2011
- Peripheral T-cell Lymphomas With a Follicular Growth Pattern are Derived From Follicular Helper T Cells (TFH) and may Show Overlapping Features With Angioimmunoblastic T-cell LymphomasThe American Journal of Surgical Pathology, 2009
- Frequent occurrence of B‐cell lymphomas in angioimmunoblastic T‐cell lymphoma and proliferation of Epstein–Barr virus‐infected cells in early casesBritish Journal of Haematology, 2007
- Morphologic and Immunophenotypic Variants of Nodal T-Cell Lymphomas and T-Cell Lymphoma MimicsAmerican Journal of Clinical Pathology, 2007
- Epstein-Barr Virus–Associated B-Cell Lymphoproliferative Disorders in Angioimmunoblastic T-Cell Lymphoma and Peripheral T-Cell Lymphoma, UnspecifiedAmerican Journal of Clinical Pathology, 2002
- Survival and Clonal Expansion of Mutating “Forbidden” (Immunoglobulin Receptor–Deficient) Epstein-Barr Virus–Infected B Cells in Angioimmunoblastic T Cell LymphomaThe Journal of Experimental Medicine, 2001