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Cytological tumour cell characteristics and reactive small lymphocytes influence patient prognosis in acute and lymphoma type adult T‐cell leukaemia/lymphoma
Author(s) -
Kobata Katsumi,
Mihashi Yasuhito,
aka Shuichi,
Matsumoto Shinji,
Kawauchi Shigeto,
Iwasaki Hiroki,
Takamatsu Yasushi,
Takeshita Morishige
Publication year - 2019
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12693
Subject(s) - medicine , lymphoma , t cell lymphoma , immunology , cancer research , pathology
Objective Acute and lymphoma type adult T‐cell leukaemia/lymphoma ( ATLL ) patients show an aggressive clinical course. While some clinical signs indicate good prognosis, definitive cytohistological prognostic factors have yet to be described. Methods We classified 65 ATLL patients into three groups by tumour cell size and nuclear pleomorphism on fine‐needle aspiration and tumour touch smear samples. Semi‐quantitative analysis of background small lymphocytes, reactive CD 20‐positive B cells and CD 8‐positive T cells was performed. Results Thirty‐one patients had pleomorphic lymphoma with predominantly medium‐sized cells and coarse granular nuclei. Another 24 patients showed pleomorphic large cell lymphoma with stippled chromatin. The remaining 10 demonstrated monomorphic large lymphoma cells with fine granular chromatin. Patients with pleomorphic lymphoma with medium‐sized cells showed significantly higher serum lactate dehydrogenase and lower CD 30 and C‐ MYC expression in lymphoma cells than the other two groups ( P = .0216, P < 0.01, respectively). Patients with pleomorphic medium‐sized ATLL had few usual small lymphocytes observed on routine morphological examination and showed less concurrent detection of CD 20‐positive B cells and CD 8‐positive T cells, both of which were lower than in the other two groups ( P = .006, P = .019, respectively). Furthermore, ATLL patients with predominantly medium‐sized lymphocytes exhibited a worse prognosis than patients with pleomorphic large cells ( P = .0197). Background small lymphocytes and concurrent detection of CD 20‐positive B cells and CD 8‐positive T cells may thus be good prognostic factors ( P = .011, P = .021, respectively). Conclusions Morphological features, size of neoplastic cells and background non‐neoplastic lymphocyte (B cells and CD 8‐positive T cells) volume appear to influence the prognosis of patients with aggressive‐type ATLL .