Refining Diagnostic Subtypes of Peripheral T-Cell Lymphoma Using a Multiparameter Approach.

Autor: Amador C; Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: catalina.amador@med.miami.edu., Weisenburger DD; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Gomez A; Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida., Bouska A; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Alshomrani A; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Sharma S; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Shah AR; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Greiner TC; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Vega F; Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas., Rosenwald A; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, Würzburg, Germany., Ott G; Department of Clinical Pathology, Robert-Bosch Krankenhaus, Stuttgart, Germany; Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany., Feldman AL; Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota., Jaffe ES; Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland., Ozkaya N; Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland., Ondrejka SL; Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio., Cook JR; Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio., Raess PW; Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, Oregon., Savage KJ; Center for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada., Slack GW; Center for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada., Song JY; Department of Pathology, City of Hope National Medical Center, Duarte, California., Scott DW; Center for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada., Campo E; Hematopathology Unit, Hospital Clinic, Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer, University of Barcelona, Barcelona, Spain., Rimsza LM; Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, Arizona., Khoury JD; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska., Staudt LM; Metabolism Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland., Chan WC; Department of Pathology, City of Hope National Medical Center, Duarte, California., Iqbal J; Department of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska. Electronic address: jiqbal@unmc.edu.
Jazyk: angličtina
Zdroj: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2024 Nov 02; Vol. 38 (2), pp. 100646. Date of Electronic Publication: 2024 Nov 02.
DOI: 10.1016/j.modpat.2024.100646
Abstrakt: Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of neoplasms, with many cases remaining unclassifiable and categorized as PTCL-not otherwise specified (PTCL-NOS). Gene expression profiling (GEP) has delineated 2 prognostic subtypes within PTCL-NOS, PTCL-TBX21 and PTCL-GATA3, characterized by distinctive transcriptomes and a different prognosis. To further evaluate the pathologic features of these subgroups, 101 PTCL cases that did not meet specific criteria for well-defined T-cell lymphoma entities underwent detailed pathologic, immunophenotypic (including T follicular helper [T FH ] biomarkers), and GEP analyses, separating them into PTCL-NOS (n = 63) and PTCL-TFH (also known as nodal PTCL-TFH, NOS, and TFH lymphoma, NOS) (n = 38). PTCL-NOS cases were further categorized into PTCL-GATA3 (n = 22; 34%) and PTCL-TBX21 (n = 41; 66%), and a significant association (P < .02) with overall survival was reaffirmed. Histopathologic assessment showed PTCL-GATA3 cases were characterized by monotonous medium-sized or large transformed cells with a minimal tumor microenvironment (TME) compared with PTCL-TBX21 cases, which consisted of pleomorphic cells in a polymorphous TME (P < .05). GEP analysis validated these TME distinctions. Immunophenotypic analysis showed that PTCL-GATA3 cases were predominantly CD4 + CD8 - and associated with significantly higher LEF1, MYC, and CD30 expression (P < .05). PTCL-TBX21 displayed a more diverse biomarker profile with the following 2 subgroups: one expressing cytotoxic antigens and enriched in CD8 + CD4 - or CD8 - CD4 - phenotype, and another lacking cytotoxic markers but showing a CD4 + CD8 - phenotype with increased ICOS expression, but devoid of other T FH markers. The PTCL-TFH cases correlated with an angioimmunoblastic T-cell lymphoma gene signature, had more Epstein-Barr encoding region-positive cells than the PTCL-GATA3 and PTCL-TBX21 cases, and a subset had some morphologic features of angioimmunoblastic T-cell lymphoma (P < .01). This study highlights the unique morphologic and phenotypic variations within the newly identified PTCL subtypes and should enable a more precise diagnosis and tailored therapeutic strategies in the future.
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Databáze: MEDLINE
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