Abstract
To describe a rare case of subcutaneous panniculitis-like T-cell lymphoma (SPTCL) with morphologic and immunophenotypic evidence of bone marrow involvement.
Biopsy specimens of skin and subcutis and bone marrow were examined using H&E-stained sections. Immunohistochemical studies for CD2, CD3, CD4, CD5, CD7, CD8, CD20, CD30, CD56, and granzyme B were reviewed. In addition, T-cell receptor γ gene rearrangement studies were performed.
A bone marrow core biopsy demonstrated several lymphohistiocytic aggregates containing atypical, cytotoxic T cells that rimmed adipocytes and were associated with karyorrhexis. These T cells were morphologically and immunophenotypically identical to a concurrent SPTCL, expressing CD2, CD3, CD7, CD8, and granzyme B but with diminished CD5 expression.
SPTCL may rarely involve the bone marrow. Bone marrow infiltrates show a similar morphologic and immunophenotypic appearance to those in the subcutaneous fibroadipose tissue, including rimming of adipocytes by neoplastic lymphocytes.
摘要
这篇文章描述了一例罕见的皮下脂膜炎样T细胞淋巴瘤病例,该病例有骨髓侵犯的形态学和免疫表型证据。皮肤、皮下和骨髓的活检标本使用HE染色观察。免疫组化进行了CD2、CD3、CD4、CD5、CD7、CD8、CD20、CD30、CD56、颗粒酶素B染色。而且进行了T细胞受体γ基因重排检测。骨髓活检观察到一些含有非典型毒性T细胞的淋巴细胞组织细胞聚合体,这些T细胞包绕在脂肪细胞周围,而且伴有核碎片。这些T细胞在形态上和免疫表型上符合皮下脂膜炎样T细胞淋巴瘤,表达CD2、CD3、CD7、CD8和颗粒酶素B,CD5弱阳性。皮下脂膜炎样T细胞淋巴瘤很少侵犯骨髓。骨髓浸润在形态上和免疫表型上与皮下纤维脂肪组织的浸润相似,如肿瘤性淋巴细胞包绕在脂肪细胞周围。
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