Unusual presentation of primary T-cell lymphoblastic lymphoma: description of two cases

Ambrosio, Maria Raffaella; Onorati, Monica; Rocca, Bruno Jim; Ginori, Alessandro; Lobello, Giuseppe; Petracco, Guido; Videtta, Alessandro Davide; Nuovo, Franca Di; Santopietro, Rosa; Lazzi, Stefano

doi:10.1186/1746-1596-9-124

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…In addition, the skin, tonsils, lymph nodes, liver, spleen, central nervous system, and male testes may also be invaded by tumor cells. [ 12 ] This case at beginning was diagnosed as T-LBL, but ended as MPAL. Honestly, there are some limitations about this case, for instance, bone marrow puncture was not performed in the beginning, so we have no idea whether the bone marrow was invaded or not?…”

Section: Discussionmentioning

confidence: 99%

Diagnostic challenges in T-lymphoblastic lymphoma, early T-cell precursor acute lymphoblastic leukemia or mixed phenotype acute leukemia

Wang

Peng²,

Deng³

et al. 2018

Medicine

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Rationale:The diagnosis of hematological malignancies depends on laboratory analysis and often requires multiple experimental methods to judge, otherwise misdiagnosis is apt to happen. Lymph node biopsy immunohistochemistry (IHC) for T-lymphoblastic lymphoma (T-LBL) requires the establishment of antibody set screening. For identifying T-LBL and early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) by lymph node biopsy and IHC, WHO has not yet proposed a better IHC antibody combination.Patient concerns:Here we reported 1 case with tortuous diagnosis experience. Initially, a 51-year-old man was diagnosed as T-LBL by lymph node biopsy, but in another hospital acute myeloid leukemia (AML) was confirmed by bone marrow puncture. Finally, it was diagnosed as mixed phenotype acute leukemia (MPAL) through our comprehensive evaluation including bone marrow cell morphology, cytochemical staining and flow cytometry analysis. Importantly, the experience about differential diagnosis and our appreciation among the T-LBL, ETP-ALL and MPAL was discussed to enlighten readers.Diagnoses:The patient was diagnosed with mixed phenotype acute leukemia (T+My)-NOS.Interventions:The patient received 1 cycle of VDCLP scheme treatment firstly. The effect of chemotherapy is satisfactory, and then he received continuous treatment and was currently in good condition.Outcomes:This patient is alive at present. The follow-up period has been 1 year.Lessons:For the diagnosis of T-LBL, the molecular markers of the myeloid and lymphoid tissues need to be included, such as CD117, CD33, Lys and MPO. The bone marrow puncture also needs to be conducted to distinguish T-LBL and T-ALL. Secondly, to identify ETP-ALL and MPAL, bone marrow cell morphology, cytochemical staining as well as flow cytometric analysis were needed to make a clear diagnosis. It is recommended that at least CD8, CD1a, Lys and MPO should be included in the panel to identify ETP-ALL.

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Section: Discussionmentioning

confidence: 99%

Diagnostic challenges in T-lymphoblastic lymphoma, early T-cell precursor acute lymphoblastic leukemia or mixed phenotype acute leukemia

Wang

Peng²,

Deng³

et al. 2018

Medicine

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“…Many previous studies have reported atypical presentations of T-cell leukaemia/lymphoma such as variable oral lesions [ 11 ] or cutaneous manifestations [ 16 ] in patients with ATL, renal infarction subsequent to polyarteritis nodosa in a patient with angioimmunoblastic T-Cell lymphoma [ 17 ], and testicular and uterine mass lesions in two patients with T-cell lymphoblastic lymphoma [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

An unusual presentation of adult T-cell leukemia/lymphoma

Tag-Adeen

Hashiguchi

Akazawa

et al. 2018

ecancer

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Adult T-cell Leukemia/Lymphoma (ATL) is a rare disease, related to human T-lymphotropic virus-1 (HTLV-1) and presented mainly in adulthood by generalised lymphadenopathy, hepatosplenomegaly, skin lesions and hypercalcaemia, with rare gastrointestinal and/or oral manifestations. We reported this case to raise awareness and demonstrate the therapeutic challenges of this rare disease. A 49-year-old Japanese female presented with skin papules on both forearms, painful mouth ulcers and multiple neck swellings since early February 2017. Initial clinical examination and laboratory investigations were misleading and her condition was diagnosed as candidiasis. Because of un-improvement of the case, a screening upper endoscopy was requested 2 months later and revealed characteristic oropharyngeal ulcers which were biopsied, and its pathologic examination confirmed smouldering type ATL. This case report should raise awareness of doctors and endoscopists about this disease especially in HTLV-1 endemic areas to avoid late diagnosis and help achieve earlier therapeutic decisions.

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“…Besides these tumors, rosettes rarely occur in lymphoma, endometrial stromal sarcoma and osteosarcoma . Here, we discuss a case of meningioma showing rosettes with collagenous cores.…”

Section: Introductionmentioning

confidence: 99%

Meningioma with rosettes: A rare morphologic pattern

2019

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We describe a case of WHO grade I transitional meningioma with rosettes in a 68‐year‐old woman. The rosettes were composed of meningothelial cells arranged around dense collagenous cores. Even though the presence of rosettes in tumors of the brain and spinal cord is an indication of neuronal or ependymal differentiation, they are also known to occur in tumors of other lineages. Rosette is an uncommon morphological pattern in meningiomas, with only few cases reported in the literature.

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Unusual presentation of primary T-cell lymphoblastic lymphoma: description of two cases

Cited by 13 publications

References 12 publications

Diagnostic challenges in T-lymphoblastic lymphoma, early T-cell precursor acute lymphoblastic leukemia or mixed phenotype acute leukemia

Diagnostic challenges in T-lymphoblastic lymphoma, early T-cell precursor acute lymphoblastic leukemia or mixed phenotype acute leukemia

An unusual presentation of adult T-cell leukemia/lymphoma

Meningioma with rosettes: A rare morphologic pattern

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