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Gastric T‐cell lymphoma with cytotoxic phenotype
Author(s) -
Sugita Shintaro,
Iijima Tatsuo,
Furuya Shuichiro,
Kano Junko,
Yanaka Akinori,
Ohta Keiichiro,
Kojima Hiroshi,
Noguchi Masayuki
Publication year - 2007
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.1440-1827.2006.02065.x
Subject(s) - lymphoma , cytotoxic t cell , pathology , malt lymphoma , bcl10 , gene rearrangement , gastric lymphoma , biology , cd8 , t cell lymphoma , stomach , b cell , antibody , antigen , medicine , immunology , gene , biochemistry , in vitro
Primary gastric lymphoma usually originates from B cells of mucosa‐associated lymphoid tissue (MALT) infected with Helicobacter pylori. When T‐cell lymphomas develop in the stomach, they usually occur in association with infection by human T‐lymphotropic virus type 1 and gastric involvement of adult T‐cell leukemia. Reported herein is a unique and informative case of gastric peripheral T‐cell lymphoma with a cytotoxic phenotype that histologically mimicked, and had to be carefully distinguished from, MALT‐type B‐cell lymphoma. The patient, a 73‐year‐old woman, underwent a gastric endoscopy examination, and the histological findings suggested MALT‐type gastric lymphoma. Analysis of the immunoglobulin heavy chain (IgH) gene and T cell receptor γ (TCRγ) gene revealed monoclonal rearrangement of the TCRγ gene. The tumor cells exhibited mild atypia and immunoreactivity with anti‐CD3, anti‐CD8, anti‐T‐cell intracellular antigen‐1, antigranzyme B and antiperforin antibodies, but not with anti‐CD20, anti‐CD10, and anti‐CD79a antibodies. The case was finally diagnosed as gastric T‐cell lymphoma with cytotoxic phenotype, and this was confirmed after surgical resection. In cases such as this, small biopsy specimens from the stomach should be examined carefully for low grade B‐cell‐type malignant lymphoma (MALT lymphoma), because sometimes the proliferating B cells can hide the truly malignant T cells, and rearrangement analysis is useful for diagnosing T‐cell malignancy.