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RECIDIVE REACTIVE LYMPHADENOPATHY (3717) » CD4.jpg
Filename: CD4.jpg
[RECIDIVE REACTIVE LYMPHADENOPATHY]
EPISODE 1 2006 07 20: 56 yrs old female presents with lymphadenopathy (PREVIOUS CASE IN HEMATOPATHOLOGY GROUP- follow the link below).  
Diagnosis was: "...NH (marginal?)lymphoma possible. Molecular evaluation and repeated biopsy is recomended."  
 
EPISODE 2 2006 09 28: Repeated biopsy (slips throw the fingers to another pathologist...):  
Diagnosis PERIPHERAL T CELL LYMPHOMA.  
 
HISTO: The T/paracortical zone is expanded by small- medium cells with the pale eo cytoplasm and irregular nuclei. Scattered RS like cells. IH: CD3+ CD4+ CD8- CD56- GranzymB-. Ki67 prolif. activity in nonfollicullar area: 30%. Some epithelioid cell clusters. Some irregular FDC proliferations. Some NONFOLLICULAR CD20+ population forms protrusions and nodules, immitating FC. Admixture of CD20+ cells and faint CD20+ areas in paracortical zone (aberrant CD20 expression on T cells?). Some strange lymphoid nodules without architecture of normal FCs("strange follicles").  
IN PROGRESS: Some double CD20/CD3 stains, EBV, CD30, etc.  
BACK TO PRIMARY BIOPSY- the same features are seen here too with less prominent T zone expansion and histiocyte clustering, but CD20+ cell admixture in "marginal" or paracortical zone is slightly obscuring the picture...  
 
QUESTION: 1. Interpretation of NH lymphoma: peripheral T NOS (T zone) or early AILT or ???  
2. Interpretation of these "pale" CD20+ cells imitating follicles.  
Thank you for continuous participation.  
Sender: ugnius
2007-09-12 18:05
INCTR - EBMWG Hematopathology Online

Last modified: 2007-09-12 18:05:20