Angioimmunoblastic T-Cell lymphoma: A critical analysis of clinical, morphologic and immunophenotypic features

• Main Authors: Bal Munita, Gujral Sumeet, Gandhi Jatin, Shet Tanuja, Epari Sreedhar, Subramanian P
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2010-10-01
• Series: Indian Journal of Pathology and Microbiology
• Subjects: Angioimmunoblastic T-cell lymphoma; immunohistochemistry; morphology
• Online Access: http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2010;volume=53;issue=4;spage=640;epage=645;aulast=Bal
• ISSN: 0377-4929; 0974-5130

<b>Background:</b> Angioimmunoblastic T-cell lymphoma (AITL), a subtype of peripheral T-cell lymphoma (PTCL), is characterized by unique clinical and biological features. Its diagnosis remains a challenge as clinical presentation as well as pathologic findings are frequently misleading. <b>Material and Methods:</b> We retrospectively analyzed the clinical, morphological and immunophenotypic spectrum of 17 cases of histologically proven AITL. <b>Result:</b> The mean age was 54 years and male to female ratio was 2.4. Common clinical features included generalized lymphadenopathy (60&#x0025;), hepatomegaly (70&#x0025;), splenomegaly (50&#x0025;), anemia (80&#x0025;) and polyclonal hypergammaglobulinemia (100&#x0025;). Microscopically, three architectural patterns; pattern I (6&#x0025;), pattern II (41&#x0025;) and pattern III (53&#x0025;) were observed. Bone marrow infiltration was seen in 60&#x0025; cases and 30&#x0025; cases revealed plasmacytosis. Absence of follicles, polymorphous infiltrate, extra-follicular follicular dendritic cell (FDC) proliferation, high endothelial venules (HEV) prominence and neoplastic T-cells were the diagnostic features of AITL. CD10 positivity (47&#x0025;), clear cells in the background (59&#x0025;) admixture with large size CD20&#x002B; B-immunoblasts (35&#x0025;) and bone marrow plasmacytosis (50&#x0025;) were common observations. <b>Conclusion:</b> Awareness of various morphological and immunophenotypic complexities of AITL and distinction from reactive adenopathies and other types of lymphomas that mimic AITL is underscored in this study.