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BMC Clin Pathol. 2013 Jun 05;13:18. doi: 10.1186/1472-6890-13-18.

Relapsed angioimmunoblastic T-cell lymphoma with acquired expression of CD20: a case report and review of the literature.

BMC clinical pathology

Yara Banz, Fatime Krasniqi, Stephan Dirnhofer, Alexander Tzankov

Affiliations

  1. Institute of Pathology, University Hospital Basel, Schönbeinstrasse 4, 4031, Basel, Switzerland. [email protected].

PMID: 23738899 PMCID: PMC3680012 DOI: 10.1186/1472-6890-13-18

Abstract

BACKGROUND: Angioimmunoblastic T-cell lymphoma is one of the most common types of peripheral T-cell lymphomas, usually presenting at an older age with an aggressive clinical course. Its characteristic morphological presentation and follicular helper T-cell phenotype help to distinguish it from other T-cell lymphomas.

CASE PRESENTATION: We recently encountered the unique case of a 63-year old patient with relapsed tumour-cell rich angioimmunoblastic T-cell lymphoma, presenting with a "classical" phenotype and, in addition, an acquired, strong, aberrant expression of CD20."Lineage infidelity" of phenotypic markers is a well-documented phenomenon in lymphomas and leukemias, a circumstance currently still poorly understood and with the potential to bring about erroneous interpretations, causing diagnostic havoc. This case represents one of the few documented angioimmunoblastic T-cell lymphomas with strong CD20 expression. Of interest, CD20 expression was only detected in the recurrent lymphoma and not upon initial diagnosis. The clinical importance of this finding lies in the potential for treatment with an anti-CD20 antibody, for instance Rituximab, in addition to standard chemotherapy protocols for angioimmunoblastic T-cell lymphoma.

CONCLUSION: Diagnostic work-up of lymphomas to determine their lineage should therefore consider morphology, pheno- as well as genotypic characteristics, where appropriate, and in particular signs of progression and change in marker profile in relapsed cases e.g. acquisition of "non-lineage" markers such as CD20 in T-cell lymphoma.

References

  1. J Exp Med. 2000 Apr 3;191(7):1137-48 - PubMed
  2. Nature. 2006 May 25;441(7092):431-6 - PubMed
  3. Nat Rev Immunol. 2005 Nov;5(11):853-65 - PubMed
  4. Leuk Lymphoma. 2012 Feb;53(2):345-7 - PubMed
  5. Ann Oncol. 2002 Jan;13(1):140-9 - PubMed
  6. Ann Hematol. 2001 Jun;80(6):372-5 - PubMed
  7. Am J Pathol. 2001 Dec;159(6):2031-43 - PubMed
  8. Haematologica. 2012 Oct;97(10):1594-602 - PubMed
  9. Mod Pathol. 2000 Jul;13(7):766-72 - PubMed
  10. Blood. 2008 May 1;111(9):4463-70 - PubMed
  11. Intern Med. 2011;50(5):495-9 - PubMed
  12. Microbiol Immunol. 1996;40(6):467-71 - PubMed
  13. Clin Adv Hematol Oncol. 2008 Dec;6(12):899-909 - PubMed
  14. Blood. 2007 Jun 1;109(11):4952-63 - PubMed
  15. Mod Pathol. 2007 Jun;20(6):632-7 - PubMed
  16. Am J Surg Pathol. 2008 Nov;32(11):1593-607 - PubMed
  17. Nat Immunol. 2003 Sep;4(9):815 - PubMed
  18. N Engl J Med. 2012 May 24;366(21):2008-16 - PubMed
  19. Am J Clin Pathol. 2001 Mar;115(3):396-403 - PubMed
  20. J Clin Oncol. 2006 Jun 1;24(16):2472-9 - PubMed

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