Original Article
Angioimmunoblastic T-cell lymphoma: histopathological grading and prognosis
Guo Yanmin, Liu Xuefei, Jiao Lijuan, Yin Shuyi, Wang Zhe, Li Xinxia, Ma Zhiping, Yang Jianmin, He Miaoxia
Published 2019-10-08
Cite as Chin J Pathol, 2019, 48(10): 784-790. DOI: 10.3760/cma.j.issn.0529-5807.2019.10.007
Abstract
ObjectiveTo investigate the histological features and prognostic factors of angioimmunoblastic T-cell lymphoma (AITL).
MethodsThe pathological data of 62 patients with AITL with complete follow-up information were retrospectively collected and analyzed from Changhai Hospital during September 2012 and September 2017. Histological and immunohistochemical (IHC) examination, in situ hybridization (ISH), and single nucleotide polymorphisms (SNP) gene mutation analysis were done. Subgroup evaluation with histology, IHC, ISH, SNP gene mutation, and association with clinical progression were performed.
ResultsThe cohort included 62 cases of AITL, including 46 males and 16 females patients, with a median age of 64 years. Follicular dendritic cells (FDC) area showed significantly expansion (≥30%) in 40 cases; increased plasma cells (≥10%) was seen in 37 cases; B cells were distributed around blood vessels in 37 cases; and increased p53 mutation positive cells (≥40%) were seen in 39 cases; high Ki-67 index (≥40%) was seen in 39 cases; RHOA mutation was seen in 19 cases; TET2 mutation was seen in 9 cases. Overall survival analysis showed these factors were significantly correlated with tumor prognosis (P<0.05). Multivariate analysis showed that CD38 positive cells<10%, Ki-67≥40%, RHOA and TET2 mutations were risk factors associated with overall survival.
ConclusionsAITL could be divided into two different prognostic groups, low-grade and high-grade, with statistically significance outcome, based on the FDC area expansion, degree of plasma cell proliferation, B cells distribution pattern combined with gene mutations and clinical progression. Low-grade malignant group progresses slowly, and high-grade malignant group is highly invasive.
Key words:
Lymphoma, T-cell; Prognosis; Morphology; Genetics
Contributor Information
Guo Yanmin
Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Department of Pathology, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201900, China
Liu Xuefei
Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Jiao Lijuan
Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Yin Shuyi
Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Wang Zhe
Department of Pathology, Xijing Hospital, Air Force Military Medical University, Xi′an, 710032, China
Li Xinxia
Department of Pathology, the First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China
Ma Zhiping
Department of Pathology, the First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China
Yang Jianmin
Department of Hematology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
He Miaoxia
Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
