Can peripheral T‐Cell lymphomas be morphologically subclassified? A morphometric approach to 21 cases

Abstract

Nantes (J.L.H.), FranceMorphometric analysis of nuclear sizes and shapes was carried out on semithin sections of lymph node for 21 patients suffering from non-Hodgkin's peripheral T-cell malignant lymphoma (ML) (excluding mycosis and Sezary syndrome). Twenty cases of B-cell ML and three cases of Sezary syndrome with massive lymph node infiltration were also studied as references, Wright and Xsaacson's recent proposals were applied to classify the peripheral T-cell MLs into monomorphic mediumcell ML (eight cases), pleomorphic ML (nine cases), and monomorphic large-cell ML (four cases). These three classes were readily distinguishable by morphometric analysis of nuclear sizes. Nuclear areas and their coeffNode-based malignant peripheral T-cell lymphomas (PTCL) are rare in Western countries. The detailed histological picture of such lymphomas is known only through publications of isolated cases or short series (1,15,17,18,23,25,33-36). The difficulty of classifying these tumors histologically was emphasized in a recent report of ours based on 16 cases of PTCL (3). In order to analyze objectively the possibility of subclassifying such lymphomas, we applied morphometric analysis of nuclear size and shapes (2830) to a series of 21 cases of PTCL, comprising nine new cases and 12 that had been previously studied (3). These cases were classified according to Wright and Isaacson's recent proposals for classifying PTCL (38) and according to the Working Formulation for Clinical Usage (22). The aim of this study was to 1) analyze the relations between morphological class, mitotic activity, and other histological parameters such as vascular hyperplasia and the quantity of eosinophils, plasmocytes, and histiocytes, 2) search for correlations between class and immunological phenotype, and 3) with the help of morphometry, arrive a t a more decients of variation were higher in pleomorphic MLs than in monomorphic mediumcell MIAs (p < 0.01). Large-cell monomorphic MLs were set apart by the histograms of their nuclear sizes. The mitoses were evaluated on histological sections and found to be more numerous in pleomorphic ML than in monomorphic medium-cell ML (p < 0.05). Nuclear irregularity in the 21 cases of peripheral Tcell ML was lower than in Sezary cells. Morphometry clearly demonstrates the morphological distinctiveness of the subclasses of peripheral T-cell ML. Their biological significance has yet to be determined. Key terms: Morphometry.~ tailed description of the subgroups of PTCL.MATERIAL AND METHODS Patients In 21 patients aged 27 to 79 years, the diagnosis of malignant lymphoma (ML) was based on a biopsy of superficial lymph nodes. All but patients 4 and 16 were of European origin. The T nature of the lymphomas was established using conventional immunological markers. Malignant cells from 15 of the patients had been studied using a panel of monoclonal antibodies including OKT4 and OKT8. All methods were previously described (3,20,21). Cases 1,7,8,[17][18][19][20] were T4+T8-, cases 3 , 5 , and 12 were T4-T8+, cases 10,13...

Clinical and biological applications of image analysis in non-Hodgkin's lymphomas

“…31 Moreover, nuclear area and its coefficient of variation are known to be important clues in recognizing the subclasses of T-cell NHL. 32 One of these, the early cutaneous T cell-lymphoma has been investigated by morphometric analysis of nuclear contour irregularities. The nuclear features of lymphoid cells may be accurately quantitated by examining with a 1000 oil immersion lens after appropriate technical procedures of tissue processing.…”