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CNS T‐cell lymphoma: an underrecognized entity?
Author(s) -
Dulai Mohanpal,
Park Christopher,
Smyth Lawrence T.,
Desai Mayuri,
Vogel Hannes
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a28-b
Subject(s) - immunophenotyping , pathology , lymphoma , cd20 , immunostaining , t cell , cd3 , medicine , gene rearrangement , biology , immunology , immunohistochemistry , antigen , cd8 , gene , immune system , biochemistry
The incidence of CNS lymphoma has increased significantly, mostly in the elderly and immunocompromised. T‐cell lymphomas (TCL) comprise 12% of systemic non‐Hodgkin lymphomas but less than 4% of primary CNS lymphomas, suggesting that they may be under recognized. In order to test this premise, we studied 3 cases of primary CNS TCL in adults aged 42, 54 and 56 years. The TCL patients had enhancing lesions by MRI, arising in the cerebellum in 1 and the temporal lobe in 2. We compared these with 3 cases of polyclonal T‐lymphocytic brain infiltrates, ages 37, 40, and 61, on the basis of testing for T‐cell receptor gene rearrangements in all cases. Both clonal TCL and oligoclonal examples showed considerable cytomorphologic heterogeneity: T‐cell markers CD3, 4, 5, 7, 8 and B‐cell marker CD20 immunostaining showed no consistent differences and all cases showed a mixed background of predominantly small T lymphocytes. The proliferation index was significantly higher in the 3 TCLs than the 2 oligoclonal cases tested for Ki‐67; EBV was detected in 1 of 2 tested TCL but not in 2 of the 3 oligoclonal infiltrates tested by in situ hybridization. We conclude that because of inconsistent differences in cytomorphology and immunophenotype, CNS TCL may not be recognized unless studies for T‐cell receptor gene rearrangements are performed in CNS mass lesions composed of a polymorphous but predominantly T‐cell infiltrate.