A case of angioimmunoblastic T-cell lymphoma coexisting with castleman disease
Angioimmunoblastic T-cell lymphoma (AITL) is a rare, mature T-cell lymphoma with diagnostic challenges. Its coexistence with Castleman disease (CD) is exceptionally uncommon and complicates diagnosis and management. We report a 67-year-old male with bilateral cervical lymphadenopathy. Imaging showed...
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| Veröffentlicht in: | Human Pathology Reports Jg. 42; S. 300798 |
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| Abstract | Angioimmunoblastic T-cell lymphoma (AITL) is a rare, mature T-cell lymphoma with diagnostic challenges. Its coexistence with Castleman disease (CD) is exceptionally uncommon and complicates diagnosis and management.
We report a 67-year-old male with bilateral cervical lymphadenopathy. Imaging showed enlarged lymph nodes with prominent vascularity and a “rim sign.” Initial pathology suggested CD, with preserved lymph node architecture, atrophic germinal centers, and “lollipop” structures. Further evaluation, however, revealed diffuse proliferation of atypical T-cells.
Immunohistochemistry showed atypical cells expressing follicular helper T-cell markers (CD10, PD1, BCL6). Molecular analysis confirmed monoclonal TCRγ gene rearrangement, and flow cytometry identified an abnormal CD4 + CD7 − T-cell clone. These findings established the diagnosis of AITL coexisting with CD.
This case highlights the high diagnostic hurdles of coexisting AITL and CD, emphasizing the critical need for comprehensive morphological, immunophenotypic, and molecular analyses for accurate diagnosis and optimal patient management. |
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| AbstractList | AbstractBackgroundAngioimmunoblastic T-cell lymphoma (AITL) is a rare, mature T-cell lymphoma with diagnostic challenges. Its coexistence with Castleman disease (CD) is exceptionally uncommon and complicates diagnosis and management. Case presentationWe report a 67-year-old male with bilateral cervical lymphadenopathy. Imaging showed enlarged lymph nodes with prominent vascularity and a “rim sign.” Initial pathology suggested CD, with preserved lymph node architecture, atrophic germinal centers, and “lollipop” structures. Further evaluation, however, revealed diffuse proliferation of atypical T-cells. Diagnostic findingsImmunohistochemistry showed atypical cells expressing follicular helper T-cell markers (CD10, PD1, BCL6). Molecular analysis confirmed monoclonal TCRγ gene rearrangement, and flow cytometry identified an abnormal CD4 + CD7 − T-cell clone. These findings established the diagnosis of AITL coexisting with CD. ConclusionThis case highlights the high diagnostic hurdles of coexisting AITL and CD, emphasizing the critical need for comprehensive morphological, immunophenotypic, and molecular analyses for accurate diagnosis and optimal patient management. Angioimmunoblastic T-cell lymphoma (AITL) is a rare, mature T-cell lymphoma with diagnostic challenges. Its coexistence with Castleman disease (CD) is exceptionally uncommon and complicates diagnosis and management. We report a 67-year-old male with bilateral cervical lymphadenopathy. Imaging showed enlarged lymph nodes with prominent vascularity and a “rim sign.” Initial pathology suggested CD, with preserved lymph node architecture, atrophic germinal centers, and “lollipop” structures. Further evaluation, however, revealed diffuse proliferation of atypical T-cells. Immunohistochemistry showed atypical cells expressing follicular helper T-cell markers (CD10, PD1, BCL6). Molecular analysis confirmed monoclonal TCRγ gene rearrangement, and flow cytometry identified an abnormal CD4 + CD7 − T-cell clone. These findings established the diagnosis of AITL coexisting with CD. This case highlights the high diagnostic hurdles of coexisting AITL and CD, emphasizing the critical need for comprehensive morphological, immunophenotypic, and molecular analyses for accurate diagnosis and optimal patient management. Background: Angioimmunoblastic T-cell lymphoma (AITL) is a rare, mature T-cell lymphoma with diagnostic challenges. Its coexistence with Castleman disease (CD) is exceptionally uncommon and complicates diagnosis and management. Case presentation: We report a 67-year-old male with bilateral cervical lymphadenopathy. Imaging showed enlarged lymph nodes with prominent vascularity and a “rim sign.” Initial pathology suggested CD, with preserved lymph node architecture, atrophic germinal centers, and “lollipop” structures. Further evaluation, however, revealed diffuse proliferation of atypical T-cells. Diagnostic findings: Immunohistochemistry showed atypical cells expressing follicular helper T-cell markers (CD10, PD1, BCL6). Molecular analysis confirmed monoclonal TCRγ gene rearrangement, and flow cytometry identified an abnormal CD4 + CD7 − T-cell clone. These findings established the diagnosis of AITL coexisting with CD. Conclusion: This case highlights the high diagnostic hurdles of coexisting AITL and CD, emphasizing the critical need for comprehensive morphological, immunophenotypic, and molecular analyses for accurate diagnosis and optimal patient management. |
| ArticleNumber | 300798 |
| Author | Wang, Long Chen, Zhongjiao Wang, Lina Zhan, Lianshan Wu, Hongyan |
| Author_xml | – sequence: 1 givenname: Lianshan surname: Zhan fullname: Zhan, Lianshan organization: Guiqian International Hospital, Guiyang City, Guizhou Province, China – sequence: 2 givenname: Long surname: Wang fullname: Wang, Long email: 18286135695@163.com organization: Guiqian International Hospital, Guiyang City, Guizhou Province, China – sequence: 3 givenname: Hongyan surname: Wu fullname: Wu, Hongyan organization: Guizhou Medical University, Guiyang City, Guizhou Province, China – sequence: 4 givenname: Zhongjiao surname: Chen fullname: Chen, Zhongjiao organization: Guiqian International Hospital, Guiyang City, Guizhou Province, China – sequence: 5 givenname: Lina surname: Wang fullname: Wang, Lina organization: Guiqian International Hospital, Guiyang City, Guizhou Province, China |
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| Keywords | PTCL-NOS Rim sign CD CT TCR FDC Castleman disease (CD) TFH HEV Angioimmunoblastic T-cell lymphoma (AITL) AITL T follicular helper (TFH) High Endothelial Venules Angioimmunoblastic T-cell Lymphoma T-cell Receptor T follicular helper Peripheral T-cell Lymphoma, Not Otherwise Specified Computed Tomography Follicular Dendritic Cell Castleman Disease |
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| Title | A case of angioimmunoblastic T-cell lymphoma coexisting with castleman disease |
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