Bone marrow involvement in lymphomas with hemophagocytic syndrome at presentation: a clinicopathologic study of 11 patients in a Western institution
| Autor: | Monique Fabre, Dominique Challine, Yves Allory, Marie-Hélène Delfau-Larue, Eric Boucher, Christiane Copie-Bergman, Corinne Haioun, Frédéric Charlotte, Marc Michel, Philippe Gaulard |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Herpesvirus 4 Human Lymphoma B-Cell Adolescent Histiocytosis Non-Langerhans-Cell Herpesvirus 6 Human medicine.disease_cause Lymphoma T-Cell Pathology and Forensic Medicine immune system diseases Bone Marrow hemic and lymphatic diseases Biopsy medicine Humans Aged Retrospective Studies CD20 biology medicine.diagnostic_test business.industry Middle Aged medicine.disease Epstein–Barr virus Immunohistochemistry Lymphoma Histiocytosis Leukemia medicine.anatomical_structure Herpesvirus 8 Human biology.protein Surgery Female Bone marrow Anatomy business CD8 |
| Zdroj: | The American journal of surgical pathology. 25(7) |
| ISSN: | 0147-5185 |
| Popis: | Hemophagocytic syndrome (HPS) is a clinicopathologic syndrome that can reveal a non-Hodgkin's lymphoma. The pathologic features of lymphoma associated with HPS remain ill defined. We studied 11 lymphomas associated with HPS on initial bone marrow biopsies, consecutively diagnosed during a 6-year period in a Western institution. There were seven diffuse large B-cell lymphomas (DLBCLs), three T-cell lymphomas (one peripheral T-cell lymphoma unspecified, two hepatosplenic gammadelta T-cell lymphomas [HS gammadeltaTLs]), and one aggressive NK-cell lymphoma/leukemia (NKL). These lymphomas shared common clinicopathologic features with a systemic presentation, a poor outcome (nine patients died within 2 years), and a mild interstitial lymphoid infiltrate of the bone marrow at presentation in nine patients. This equivocal lymphoma infiltrate was blending with normal hematopoietic cells, and CD20 and CD3 immunolabelings were essential for its detection. A high number of reactive T (CD3+) cells, most often with a predominant cytotoxic (CD8+ TiA1+) phenotype, was present in all DLBCLs. By in situ hybridization, Epstein-Barr virus was detected in neoplastic cells of three cases (one DLBCL, one HS gammadeltaTL, and one NKL), which also showed serum viral DNA. Polymerase chain reaction studies disclosed HHV6 DNA sequences in tumor tissues of two DLBCLs, whereas HHV8 DNA was not detected. Because tumor mass indicative of lymphoma was not striking in most patients, bone marrow biopsy appears to be of great value for the diagnosis of an HPS-associated lymphoma, which may be, in Western patients, of B- as well as T- or NK-cell type. Immunostaining for CD3 and CD20 is essential to identify the common subtle lymphoma involvement. Together with a better understanding of the pathogenic processes, an early diagnosis may improve the prognosis of HPS-associated lymphoma. |
| Databáze: | OpenAIRE |
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