Diagnostic features of peripheral T cell lymphoma, not otherwise specified

Abstract

Objective To investigate the clinical and pathological features of peripheral T cell lymphoma, not otherwise specified (PTCL-NOS), and method of diagnosis and treatment. Methods The medical record of a 50-year-old man with PTCL-NOS admitted to Taian Central Hospital on September 4th, 2017 was analyzed and the related literature was reviewed. Results A peanut-sized lymph node behind the right ear was touched 50 days ago, and increased significantly to quail egg-like size with tenderness 3 days ago. Thyroid hormones and tumor markers were all in normal level. The results of color Doppler ultrasonography showed that bilateral submandibular, bilateral neck, bilateral supraclavicular and bilateral axillary lymph nodes were enlarged. Ultrasound examination also found bilateral inguinal lymph nodes slightly enlarged, abdominal lymph nodes enlarged and splenomegaly. CT showed patchy shadow on the lower lobe of the right lung, small nodules in both lungs, and enlarged mediastinal lymph nodes. Bone marrow morphology showed abnormal juvenile cells (considered as lymphoma cells) accounted for 14.5%; approximately 35.09% of CD4-CD8+ abnormal lymphocytes were found with flow cytometry; they were considered as T cell lymphoma leukemia origin. PTCL-NOS was determined with the pathological examination. Immunohistochemical results of lymph nodes biopsy showed that cluster of differentiation 3(CD3), CD5, CD2, CD7, CD23 (follicular dendritic cell, FDC), CD21 (FDC), CD20 (B Cell) were all positive; B-cell lymphoma 2(BCL-2), CD45RO, CD56 and Granzyme B were weakly positive; B cell specific activation protein5 (PAX-5), CyclinD1, perforin and T cell intracellular antigen were negative; and Ki 67 accounted over 15%. Conclusions PTCL-NOS is a rare type of lymphoma. It develops rapidly and has high invasion. At present, lots of treatment methods are not ideal and the prognoses are poor. The development and application of new drugs is imperative. Key words: Peripheral T cell lymphoma, not otherwise specified; Lymphoma; Lymph nodes biopsy; Immunophenotype