Histologic evolution of angioimmunoblastic T-cell lymphoma in consecutive biopsies: Clinical correlation and insights into natural history and disease progression

Ayoma Deepthi Attygalle, Charalampia Kyriakou, Jehan Dupuis, Karen Lynne Grogg, Timothy Charles Diss, Andrew Charles Wotherspoon, Shih Sung Chuang, José Cabeçadas, Peter Gershon Isaacson, Ming Qing Du, Philippe Gaulard, Ahmet Dogan

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Abstract

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon, but aggressive nodal peripheral T-cell lymphoma. Little is known of its biology and its natural history has been poorly studied. We report the first comprehensive study on the natural history/histologic progression of AITL by reviewing consecutive biopsies in 31 cases. Immunostaining for CD3, CD20, CD10 and CD21, CD23, CNA-42, CD4, CD8, and Ki 67, in situ hybridization for Epstein-Barr virus (EBV)-encoded RNA and polymerase chain reaction for T-clonality and B-clonality were performed. Histologic progression from AITL with limited nodal involvement and hyperplastic follicles (pattern I) to typical AITL with or without regressed follicles (patterns II and III) was observed in 7 cases, one of which relapsed subsequently as pattern I. Thirteen cases showed typical AITL at presentation and follow-up. Eleven cases where polymerase chain reaction results for T-cell receptor-γ gene rearrangement were directly compared showed an identical band-size in the initial and follow-up biopsies. Seven cases (23%) developed EBV-associated B-cell lymphomas [5 diffuse large B-cell lymphoma (DLBCL) and 2 classic Hodgkin lymphoma]. In 4 cases, a dominant B-cell clone was observed in biopsies lacking evidence of DLBCL. A single case was complicated by EBV-negative DLBCL, whereas another with large cell transformation had a T-cell phenotype. In conclusion, AITL represents a clonal T-cell proliferation with a stable T-cell clone throughout the disease. Partial nodal involvement with hyperplastic follicles is seen in early AITL and at relapse. When "morphologic high-grade transformation" occurs, it is usually due to a secondary (often EBV-associated) B-cell lymphoma, rather than a T-cell neoplasm.

Original languageEnglish (US)
Pages (from-to)1077-1088
Number of pages12
JournalAmerican Journal of Surgical Pathology
Volume31
Issue number7
DOIs
StatePublished - Jul 2007

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T-Cell Lymphoma
Natural History
Disease Progression
Biopsy
Human Herpesvirus 4
Lymphoma, Large B-Cell, Diffuse
B-Cell Lymphoma
T-Lymphocytes
Clone Cells
T-Lymphocyte Gene Rearrangement
Peripheral T-Cell Lymphoma
T-Cell Receptor Genes
Polymerase Chain Reaction
DNA-Directed RNA Polymerases
Hodgkin Disease
In Situ Hybridization
B-Lymphocytes
Cell Proliferation
Phenotype
Recurrence

Keywords

  • Angioimmunoblastic T-cell lymphoma
  • Natural history
  • Progression

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Histologic evolution of angioimmunoblastic T-cell lymphoma in consecutive biopsies : Clinical correlation and insights into natural history and disease progression. / Attygalle, Ayoma Deepthi; Kyriakou, Charalampia; Dupuis, Jehan; Grogg, Karen Lynne; Diss, Timothy Charles; Wotherspoon, Andrew Charles; Chuang, Shih Sung; Cabeçadas, José; Isaacson, Peter Gershon; Du, Ming Qing; Gaulard, Philippe; Dogan, Ahmet.

In: American Journal of Surgical Pathology, Vol. 31, No. 7, 07.2007, p. 1077-1088.

Research output: Contribution to journalArticle

Attygalle, AD, Kyriakou, C, Dupuis, J, Grogg, KL, Diss, TC, Wotherspoon, AC, Chuang, SS, Cabeçadas, J, Isaacson, PG, Du, MQ, Gaulard, P & Dogan, A 2007, 'Histologic evolution of angioimmunoblastic T-cell lymphoma in consecutive biopsies: Clinical correlation and insights into natural history and disease progression', American Journal of Surgical Pathology, vol. 31, no. 7, pp. 1077-1088. https://doi.org/10.1097/PAS.0b013e31802d68e9
Attygalle, Ayoma Deepthi ; Kyriakou, Charalampia ; Dupuis, Jehan ; Grogg, Karen Lynne ; Diss, Timothy Charles ; Wotherspoon, Andrew Charles ; Chuang, Shih Sung ; Cabeçadas, José ; Isaacson, Peter Gershon ; Du, Ming Qing ; Gaulard, Philippe ; Dogan, Ahmet. / Histologic evolution of angioimmunoblastic T-cell lymphoma in consecutive biopsies : Clinical correlation and insights into natural history and disease progression. In: American Journal of Surgical Pathology. 2007 ; Vol. 31, No. 7. pp. 1077-1088.
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