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Hepatosplenic γδ T‐cell lymphoma following seven malaria infections
Author(s) -
Hassan Rocío,
Franco Sergio A. L.,
Stefanoff Claudio Gustavo,
Romano Sergio O.,
Diamond Hilda R.,
Franco Luiz G. P.,
Seuánez Héctor N.,
Zalcberg Ilana R.
Publication year - 2006
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2006.02027.x
Subject(s) - lymphoma , t cell receptor , biology , immunology , cd5 , cd8 , malaria , t cell , pathology , virology , medicine , antigen , immune system
Hepatosplenic γδ T‐cell lymphoma (HSTL) is a clinicopathological entity associated with an immunocompromised status in approximately 25% of patients. Herein is described a case of HSTL in a 53‐year‐old Brazilian man with seven previous malaria infections, initially misdiagnosed as a hyperreactive splenomegaly due to chronic malaria. A characteristic lymphoid infiltrate was observed in spleen, liver and bone marrow sinusoids/sinuses. Neoplastic cells had a CD45RO+, CD2+, CD7+, CD3+, CD5–, CD8+, CD56+, perforin+, FasL‐negative, T‐cell receptor (TCR)αβ‐negative, TCRγδ+ profile. Analyses of γ and δ TCR rearrangements confirmed diagnosis of γδ T‐cell lymphoma by detecting VγI/Vδ1‐Jδ1 clonal rearrangements. Sensitive polymerase chain reaction (PCR) for Plasmodium falciparum , Epstein–Barr virus and herpesvirus‐8 failed to demonstrate infection. The disease progressed to a fatal outcome following cutaneous infiltration and leukemic proliferation. The authors also comment on the association of lymphoma and infection, focusing on PCR diagnosis of TCRγ and δ clonal rearrangements and the presumed pathogenic events leading to HSTL in the context of chronic malaria infection. Initial lymphomagenic stages might not be direct consequences of antigenic stimulation of Vδ1 T‐cells, but might depend on interactions between γδ T and B cells during cooperative or regulatory responses to Plasmodium sp.