Proliferation Of Neoplastic Lymphoid Cells Research Articles

Clinico-pathological analysis of primary breast lymphoma: A cross sectional study in a tertiary care hospital

Introduction: Breast being well-developed mammary organ in females is a common site for many non-neoplastic and malignant lesions due to varied underlying etio-pathogenesis. Lymphoma being a malignant clonal proliferation of lymphoid cells, primary breast lymphoma is an unusual entity with non-epithelial origin characterized by florid proliferation of neoplastic lymphoid cells. With uncertain etiology, the clinical presentation is vague with varied radiological and histopathological patterns. In the present study, we analyzed the incidence of primary breast lymphoma with a study on clinico-histopathological pathological spectrum. Methodology: The study was conducted retrospectively and included patients with breast lesions and the histopathological evaluation from their subsequent tissue biopsies. All the clinical data was documented and cytological correlation were done in available cases. Hematological and radiological interpretations are analyzed subsequently as pre-op work up of the patients. Clinico-pathological analysis of the results were done based on knowledge from research works. Results and Observation: The seven years retrospective study included nine cases which fell into the criteria of PBL with average age incidence between 4th & 5th decade occurring retroareolar region with right breast preponderance. Radiological studies picked up malignancy only in few cases but categorization of lymphoma were not reported by imaging. Hematological parameters showed anaemia, leucopenia and pancytopenia depending on extent and involvement of the bone marrow. Histomorphology and subsequent IHC expression stayed gold standard role in diagnosis compared to radiological interpretations. Conclusion: Primary breast lymphoma is rare type of breast cancer with varied presentation. Any patient presenting with solitary, lobulated breast lump in 5th decade, PBL should be kept as one of the differentials especially with anaemia and axillary node enlargement. Clinico-hematological correlation with subsequent histomorphology helps the Pathologist is diagnosing the condition thereby aiding the in Prompt management. Keywords: Breast Lymphoma, Hematological parameters, Histopathology, IHC, Radio-imaging.

Clinicoepidemiological profile of extranodal lymphoma: The experience of a tertiary care center in India

Introduction: Lymphoma is a neoplastic proliferation of lymphoid cells at various stages of differentiation and affects lymph nodes, with infiltration into the bone marrow, spleen, and thymus, which form the primary lymphatic organs. Extranodal lymphoma, by definition, involves sites other than lymph nodes, spleen, thymus, and the pharyngeal lymphatic ring. Extranodal involvement is less common with Hodgkin lymphoma (HL) than with non-Hodgkin lymphoma (NHL). Materials and Methods: A single-center retrospective observational study was conducted over the period of 2017–2019. Age, gender, histologic type, location, type of clinical presentation, histologic diagnosis, and presence of specific symptoms were recorded, as were the specialty of the physician initially consulted and of the physician taking the diagnostic sample. Results: Twenty-seven cases of extranodal lymphoma were diagnosed: 12 (44.4%) were male and 15 (56.6%) were female patients. The median age for males was 49.6 years and for females was 45.7 years. In this study, we had varied presentations of the lymphoma with involvement of various structures. We had few patients with very rare site of involvement like an elderly female patient presented with firm swelling over the right forearm which on excision turned out to myeloid sarcoma. Similarly, an elderly woman had presented with pyrexia of unknown origin that was later diagnosed as having primary bone Hodgkin lymphoma (HL) which is a very rare diagnosis and rarely has been described in world literature. The most common site of extranodal lymphoma was gastrointestinal tract (7 out of 27 patients; 25.9%); the other sites reported were testis (14.8%), breast (7.4%) thyroid, and ovary. Few rare sites reported were bone, central nervous system, and mediastinum. We report an extremely rare patient who had presented with anterior chest wall swelling, and on evaluation was detected to have primary mediastinal B cell lymphoma. Conclusion: Extranodal lymphoma is the rare presentation of NHL and extremely rare for HL. As it is a very rare disease, there are very limited studies available for its staging and management. We have presented a case series of extranodal lymphoma with few very rare presentations.

Linfossarcoma de células B multicêntrico em uma ovelha

Background : : : Lymphosarcoma is a malignant tumor from tumoral cells similar to lymphocytes and its spontaneous development in small ruminants is unusual in Brazil. In cattle, the lymphosarcomas are often associated with infection by bovine leukemia virus (BLV), although sheep are considered as a very susceptible specie to BLV. Spontaneously lymphosarcoma is rare and in most cases it is observed in apparently healthy animals in slaughterhouses. There is no report of this tumor in sheep in southern Brazil. We describe a case of spontaneous multicentric B-cells lymphosarcoma in an ewe. Case : In June 2007, a 4-years-old mixed breed ewe was necropsied after clinical signs as anorexia, weight loss and death in few weeks. This ewe was purchased in September 2006 with another 44 sheep, most females of the same age. Dairy cattle were also raised together with sheep at the same farm. Fragments of liver, lung, spleen, kidneys, brain and parotid lymph node were sent to the Veterinary Pathology Laboratory - Universidade Federal de Santa Maria, Brazil, for histopathological evaluation. Multiply white to yellow nodules, with 0.5 to 2 cm of diameter, were observed in the liver, kidneys, and the parotid lymph node. The nodules were soft and some coalesced and infiltrating the hepatic parenchyma. The kidneys nodules were similar to those of the liver but prominent in the capsule. They were observed infiltrating more intensely the cortical region. The parotid lymph node was 6 x 4 x 3.5 cm size, whitish, multilobulated and the cut surface was totally obliterated by the tumor mass. Histologically, the neoplasm showed intense proliferation of neoplastic lymphoid cells arranged in sheets and a poor fibrovascular stroma, with round small and hyperchromatic nuclei, and scarce eosinophilic cytoplasm compressing the adjacent parenchyma. Immunohistochemistrily, neoplastic cells were strongly positive for anti-CD79a antibody and negative for anti-CD3 antibody, indicating neoplastic cells derived from B lymphocytes. Discussion : The diagnostic of multicentric B-cell lymphosarcoma was made based on gross, histological, and immunohistochemical findings. Spontaneous development of this tumor is uncommon in sheep in Brazil. The multicentric presentation seen in this case is the most common form of lymphosarcoma in sheep, although the thymic and cutaneous forms also occur. Sheep affected by multicentric lymphosarcomas may have symmetrical lymphadenopathy, not observed in this case, and involvement of various organs including liver, kidney, spleen, intestine, skeletal muscle and heart. However, under experimental conditions, these tumors are easily induced after inoculation of bovine retrovirus (BLV) in sheep, by its high sensitivity. Possibly, the spontaneous transmission of BLV from cattle developing the disease in sheep may occur in Brazil as well as in other countries. Epidemiological factors of the disease are not established yet. Despite this, some correlation must exist for the low occurrence of this disease in sheep in properties of southern Brazil, where cattle and sheep are commonly raised together, and the frequency of lymphosarcoma in sheep is low. In this case, the association of BLV with development of the neoplasm could not be confirmed. This is the first report of multicentric B-cell lymphosarcoma in sheep diagnosed in southern Brazil.

Analyses on Activation of NF-κB and Effect of Bortezomib in Canine Neoplastic Lymphoid Cell Lines

Lymphoid malignancies, such as leukemia, and many types of lymphoma are common and severe disorders in dogs. Since shortening remission duration caused by resistance to chemotherapy often becomes clinically critical problems, development of novel and effective therapy should be required. The present study investigated the status of NF-κB and effect of its inhibitor, bortezomib, in six canine neoplastic lymphoid cell lines. NF-κB p65 and p50 were detected in the nuclear fraction of GL-1, CLBL-1 and CL-1, suggesting that NF-κB was constitutively activated in the cells. NF-κB p65 was detected in the cytoplasmic fraction of UL-1 and Ema. After incubation with bortezomib, NF-κB p50 and p65 became undetectable in the nuclear fraction of GL-1, CLBL-1 and CL-1, and CLBL-1, respectively, and p65 was clearly degraded in the cytoplasmic fraction of CLBL-1 and CL-1. Bortezomib inhibited the proliferation of all cell lines except Nody-1 in a concentration-dependent manner. The results indicated that constitutive activation of NF-κB could contribute to the proliferation of canine neoplastic lymphoid cells, and bortezomib would have suppressive effects on the NF-κB activation and the proliferation of neoplastic lymphoid cells in dogs.

Spontaneous T/NK-cell Lymphoma associated with Simian Lymphocryptovirus in a Japanese Macaque (Macaca fuscata)

A 5-year-old female Japanese macaque (Macaca fuscata) was humanely destroyed because of severe anaemia with poor response to treatment. At necropsy examination, marked splenomegaly and systemic enlargement of lymph nodes were observed. Microscopical examination revealed diffuse proliferation of neoplastic lymphoid cells in the spleen and lymph nodes with infiltration of the liver, lung, gastrointestinal tract, kidney and bone marrow. Immunohistochemically, the neoplastic cells expressed CD3 and CD4, but not CD20, CD79α or CD8, consistent with a T helper phenotype. A portion of neoplastic cells expressed the natural killer (NK) cell marker CD56. In-situ hybridization detected Epstein-Barr virus (EBV)-encoded small RNAs in the neoplastic cells, indicating the involvement of simian lymphocryptovirus (LCV). This is the first report of simian LCV-associated T/NK-cell lymphoma with the predominant expression of T-cell antigens in non-human primates.

Extranodal manifestations of lymphoma on [18F]FDG-PET/CT: a pictorial essay

Lymphoma is the seventh most common type of malignancy in both sexes. It is a neoplastic proliferation of lymphoid cells at various stages of differentiation and affects lymph nodes with infiltration into the bone marrow, spleen and thymus. However, extra nodal involvement is frequently seen in many cases. With the development of dedicated positron emission tomography (PET) scanners with fused computed tomographic (CT) systems in the same gantry, [18F]fluorodeoxyglucose (FDG)-PET/CT has become a major tool in the evaluation of lymphomas and it is inimitable in certain situations such as assessment of response to therapy. Extranodal lymphoma can present with diverse manifestations and sometimes mimics other organ-related pathologies. Knowledge of the protean manifestations of extranodal lymphoma is required to accurately detect the disease and differentiate it from the various physiologic and benign causes of FDG uptake in various organs. We present a case series of extranodal involvement of histologically proven cases of lymphomas detected on FDG-PET/CT at our institute to demonstrate the challenges in interpretation of extranodal lymphoma.

Linfoma B intravascular: comprometimento bilateral da suprarrenal em paciente adulta jovem

The Intravascular Large B-cell Lymphoma (IVLBCL) is a rare disease characterized by neoplastic proliferation of lymphoid cells within capillaries. We report a case of IVLBCL in a young female patient with bilateral involvement of the adrenal gland. Immunohistochemical examination confirmed IVLBCL. The relationship between endocrine organs and lymphoid cells is a hypothesis to explain the correlation observed between IVLBCL and the involvement of the adrenal gland. Moreover, the association between IVLBCL and the described symptomatology seems to reflect a pattern that may assist in a more effective diagnosis.

Anaplastic large cell lymphoma: changes in the World Health Organization classification and perspectives for targeted therapy

Anaplastic large cell lymphoma (ALCL) was first described in 1985[1][1] as a neoplastic proliferation of lymphoid cells that are anaplastic in appearance ([Figure 1A][2]), have a propensity to grow cohesively, invade lymph node sinuses ([Figure 1B][2]) and consistently express the CD30 molecule.[2][

Intravascular Large B-cell Lymphoma with Bone Marrow Involvement: A Case Successfully Treated with a Rituximab-CHOP Combination Regimen

Intravascular large B-cell lymphoma is rare and generally fatal. It is defined pathologically by neoplastic proliferation of lymphoid cells within the lumens of capillaries, small veins, and arteries with little or no other parenchymal involvement. The diagnosis can be delayed because of the rarity of the disease and the difficulty of detection in imaging studies, and a suspicious clinical observation is warranted to make the correct diagnosis. Early diagnosis is important because delayed treatment could result in a fatal outcome. We have encountered a case of intravascular large B-cell lymphoma involving only the bone marrow. An early diagnosis was made and the patient was treated with combination chemotherapy and rituximab targeting CD20. The patient went into complete remission after the third cycle of chemotherapy and maintained a disease free state up to 6 months. (Korean J Hematol 2006;41:306-310.)

Intravascular Lymphoma: Case Series and Review of the Literature.

Background: Intravascular lymphoma is a rare and aggressive form of non-Hodgkin lymphoma defined pathologically by neoplastic proliferation of lymphoid cells within the lumens of small to medium sized blood vessels, with little or no parenchymal involvement. Most intravascular lymphomas are of B-cell origin while a minority are T-cell. Neoplastic cells localize within vascular lumina but rarely infiltrate other areas associated with lymphoma such as lymph nodes, bone marrow, or peripheral blood. The mechanism for the intravascular localization of these cells remains unexplained. Intravascular lymphoma has an extremely poor prognosis; usually patients exhibit nonspecific clinical presentations that make diagnosis difficult. We report a series of three patients with intravascular lymphoma at our institution with a review of the published literature and discuss its presentation and clinical implications.Cases:A 62 year old male presented with lower extremity weakness and numbness associated with bowel and bladder incontinence. MRI of his brain and thoracic spine revealed advanced chronic ischemic changes with areas of acute infarct, and T4-T6 transverse myelitis, respectively. He developed fevers, had one positive blood culture, and clinically demonstrated a progressive neurologic deterioration. Autopsy revealed intravascular large B-cell lymphoma cells involving small vessels within the liver, spleen, kidneys, and most extensively within the brain & spinal cord. Vascular occlusion by lymphoma cells in the brain & spinal cord led to multiple infarcts and thus a rapid neurologic decline.A 76 year old female presented with a two month history of fever, malaise, weight loss, and generalized weakness. She was found to have ascites, anasarca, and hypoalbuminemia. All cultures and diagnostic tests were unrevealing. She demonstrated multi-organ system failure and deteriorated, expiring on hospital day eleven. Post mortem exam revealed intravascular large B-cell lymphoma in small vessels within the colon, liver, epicardium, lungs, and hepatic sinusoids. Small vessels in soft tissue adjacent to the thyroid and adrenal glands also contained malignant cells.A 58 year old female presented with a two year history of recurring erythematous, tender, thickened areas of the lower extremities associated with fevers and malaise. Skin biopsy of an indurated thigh lesion revealed intravascular lymphoma. She was treated with six cycles of CHOP chemotherapy and achieved complete clinical remission with no evidence of recurrence over many years of close surveillance.Methods: A PubMed search, English language medical literature, using key words “intravascular lymphoma” and “angiotrophic lymphoma.”Conclusion: Intravascular lymphoma is a rare type of lymphoma with a poor prognosis. It has an aggressive clinical course with proliferation of neoplastic cells within blood vessels of organs, resulting in luminal thrombosis and thus multi organ system manifestations, although there is a higher incidence of cutaneous and central nervous system abnormalities. The medical literature indicates that few cases are diagnosed antemortem because often presenting signs are unlike those of lymphoma. There is favorable response to chemotherapy provided the diagnosis is considered and made. The diagnosis of intravascular lymphoma must be considered in the patient who presents with fever of unknown origin associated with neurologic signs and /or skin changes. Progression of the disease usually involves multi organ system manifestations with only rare involvement of lymph nodes and bone marrow. Diagnosis is confirmed by biopsy.

Expression of BAFF-R (BR3) in normal and neoplastic lymphoid tissues characterized with a newly developed monoclonal antibody

BAFF-receptor (BAFF-R) is required for the successful maturation and survival of B-cells. We developed an anti-human BAFF-R monoclonal antibody (mAb), 8 A 7. The reactivity of 8 A 7 in normal and neoplastic tissue was examined by performing immunohistochemistry on paraffin-embedded sections. 8 A 7 reacted with lymphocytes in the mantle and marginal zones, but not with lymphocytes in the interfollicular area. Lymphocytes in the germinal centers were found to be negative or occasionally weakly positive for 8 A 7. BAFF-R expression was found only in B-cell lymphoma (44/80, positive cases/examined cases): B-lymphoblastic lymphoma 0/3, B-chronic lymphocytic leukemia/small lymphocytic lymphoma 4/4, mantle cell lymphoma 9/11, follicular lymphoma 10/14, diffuse large B-cell lymphoma (DLBCL) 11/25, marginal zone B-cell lymphoma 8/10, lymphoplasmacytic lymphoma 2/2, plasma cell myeloma 0/2, and Burkitt lymphoma 0/9, but not in T/NK cell lymphomas (0/19) or Hodgkin lymphoma (0/10). BAFF-R was expressed in most low-grade B-cell neoplasms and a small number of DLBCL, suggesting that BAFF-R may play an important role in the proliferation of neoplastic lymphoid cells. Thus, the mAb is very useful for further understanding of both healthy B-cell biology and its pathogenic neoplasms.

Intravascular lymphomatosis of the CNS responds to initial treatment with CNOP and rituximab

6743 Background: Intravascular lymphomatosis (IVL) is a neoplastic proliferation of lymphoid cells within the lumen of blood vessels with little or no parenchymal involvement. It is rare, has a poo...

Severe pulmonary arterial hypertension as initial manifestation of intravascular lymphoma: Case report

Intravascular lymphoma (IVL) is a rare and usually fatal disease that belongs to the class of high-grade malignant lymphomas and which is characterized by proliferation of neoplastic lymphoid cells exclusively within the lumina of small blood vessels. Its polymorphic and nonspecific clinical manifestations make antemortem diagnosis very difficult. We report herein a case of IVL revealed by fatal, precapillary, pulmonary arterial hypertension and associated with long-lasting fever. Extensive investigation of the usual causes of pulmonary arterial hypertension was negative. The diagnosis of intravascular lymphoma was made on postmortem analysis, revealing diffuse and sometimes complete obliterations of the lumina of small blood vessels by large B-cell lymphoma, including pulmonary capillaries. Thus, we propose that IVL must be added to the spectrum of etiologies of subacute pulmonary arterial hypertension, notably in the context of associated fever, both entities requiring emergency diagnosis. For this purpose, blood collected via pulmonary capillary-wedge aspiration for cytologic examination may be associated with right-sided heart catheterization when this latter procedure is suitable.

Intravascular Lymphoma with NK Cell Immunophenotype

Intravascular Lymphoma is a rare extranodal large cell lymphoma characterised by a neoplastic proliferation of lymphoid cells in small vessel lumina typically involving the skin and central nervous system. The malignant cells are most commonly of B cell origin, although rare T cell variants have been described. We report a rare case of intravascular lymphoma with an NK cell phenotype. The patient is a 65 year‐old man with a 5 year history of hypogammaglobulinemia and a six month history of tinea corporis involving the legs. Following topical antifungal treatment.asymptomatic erythematous plaques were noted on the lower extremities. A skin biopsy revealed intravascular thrombi with atypical malignant lymphoid cells which were immunoreactive for: CD3, CD2, LCA, CD56, perforin, granzyme B, and TIA‐1. There is one description of an NK‐like intravascular lymphoma in the literature and one of the authors (G.P.) has recently described two patients with intravascular lymphoma of definitive NK cell type (submitted for publication). Intravascular lymphoma is an aggressive malignancy with a poor prognosis. Recognition of this newly described variant will help to elucidate our understanding of its pathogenesis and natural history.

Angiotropic Large-Cell Lymphoma Presenting as Pulmonary Small Vessel Occlusive Disease

Angiotropic lymphoma (AL) is an unusual variant of extranodal lymphoma, characterized by massive proliferation of neoplastic lymphoid cells almost exclusively within blood vessels. Whereas the lymphoid origin of this disease is widely accepted it still remains unclear whether AL is a distinct entity that originates in the blood vessels or whether it represents a form of secondary intravascular dissemination of a primary solid lymphoma. The present case is unusual because death by right heart failure owing to extensive intravascular proliferation of neoplastic cells and subsequent occlusion of pulmonary blood vessels has not been described so far. In addition, the patient had suffered from a solid deposit of a large-cell B-lymphoma months before the angiotropic manifestation, suggesting that AL might develop out of more common types of non-Hodgkin's lymphomas.

Intrasinusoidal Bone Marrow Infiltration Revealing Intravascular Lymphomatosis

Intravascular lymphoma is a rare, often fatal disease characterized by a widespread intravascular proliferation of neoplastic lymphoid cells. Dermatological and bizarre neurological manifestations usually predominate. We report a case of intravascular lymphomatosis with an exceptional clinical presentation showing splenomegaly combined with early bone marrow involvement. The diagnosis was made on bone marrow biopsy examination using both immunohistochemistry and molecular biology analysis. We stress the histopathological features of bone marrow involvement by intravascular lymphoma which allow the prompt recognition of this disease. Early systemic chemotherapy, which represents the only chance of remission in such an agressive disease, can then be initiated.

Intravascular lymphomatosis of the brain: a diagnostic problem

Intravascular lymphomatosis (of B- or T-cell origin) is a rare lymphoproliferative disorder characterised by neoplastic proliferation of lymphoid cells within the lumen of capillaries, small veins and arteries with no or minimal involvement of the parenchyma. Its predilection sites are the skin and the brain. We studied a 44-year-old man who presented with a 2 year history of unexplained LDH elevation followed by a neurological syndrome without systemic involvement. Brain biopsy showed an intravascular lymphoma of the B-cell lineage. This report illustrates the diagnostic challenge of this rare disorder with a grim prognosis.

Intravascular Lymphomatosis-An Indolent or Aggressive Entity?

Intravascular lymphomatosis (IVL) is a rare malignancy characterized by neoplastic proliferation of lymphoid cells within the lumens of arteries, small veins and capillaries. We report four patients with IVL and review the recent world literature, relating to incidence, clinical features and possible therapy. In these cases diagnosis was established coincidentally in one patient after prostatectomy. This patient eventually had central nervous system involvement. In two other patients IVL was diagnosed from skin lesions. In the fourth case the diagnosis was established at post-mortem examination, where involvement of most organs was evident but particularly kidneys, myocardium, gastrointestinal tract and lymph nodes. Therapy was given to three patients, but the disease progressed in two and they both died with evidence of central nervous system involvement, while the third patient has had a good partial response to combination chemotherapy but has relapsed within two months of completing chemotherapy. As evident from our patients and the literature review IVL has a variable clinical course and currently, there appears to be no effective therapy for this rare disorder.

Four varied cases of intravascular lymphomatosis and a literature review

Intravascular lymphoma (IVL) is an uncommon malignancy defined pathologically by neoplastic proliferation of lymphoid cells within the lumens of capillaries, small veins, and arteries, with little or no adjacent parenchymal involvement. The nature of IVL has been the subject of considerable controversy. Recent immunohistochemical studies have demonstrated clearly that the tumors bear the immunophenotype of neoplastic lymphoid cells of either B-cell or T-cell lineage. IVL commonly affects the central nervous system, resulting in progressive dementia and multiple neurologic deficits; skin is the second most common site of involvement, in the form of cutaneous plaques and nodules. In a retrospective review of all cases of non-Hodgkin's lymphoma seen at our institution, four cases of IVL were identified. Case 1 was fixed in methacarin, and Cases 2-4 were fixed in 10% formalin. Standard fixation, tissue processing, sectioning, and hematoxylin and eosin staining were used. Immunophenotypic studies were performed using a modified avidin-biotin complex technique. The specimen in Case 1 was stained by Giemsa stain using standard techniques. Four cases of IVL are presented. One patient experienced hypoxemia and fevers of unknown origin; the second, dementia and a vasculitislike illness; the third rapidly progressive dementia, nonlocalizing neurologic deficits, and panhypopituitarism; the fourth Kaposi-like skin lesions. Case 1 relapsed shortly after completing chemotherapy. Salvage chemotherapy has yielded good initial response. Autopsy findings in cases 2, 3 and 4 confirmed IVL in many vessels, including the brain, lung, liver, heart, gastrointestinal tract, glomerulus, central nervous system, and skin. Malignant lymphoid cells marked as B-cells in all cases. Unusual and interesting clinical presentations may occur in patients with IVL. The medical literature indicates that few cases are diagnosed ante mortem. Although isolated patients may respond favorably to chemotherapy, most will deteriorate rapidly and the diagnosis of IVL not contemplated until necropsy.

Peripheral T-cell lymphomas. Immunologic and enzyme histochemical analysis of 15 cases.

Fifteen cases of peripheral T-cell lymphoma were studied to evaluate the respective properties of various histologic types using enzyme histochemical and ultrastructural examinations in addition to immunological methods. Eleven cases in an ATLA-negative group manifested various histologic patterns such as IBL-like, pleomorphic and Lennert's lymphomas in comparison with the relatively monomorphic proliferation of neoplastic lymphoid cells in the 4 ATLA-positive cases. The presence of neoplastic clear cells is characteristic of peripheral T-cell malignancies, and is likely to be found in CD4+ lymphomas. There is an occasional reaction of epithelioid histiocytes and plasma cells with eosinophils, the former being designated Lennert's lymphoma and the latter IBL-like T-cell lymphoma. Immunological examination revealed four immunophenotypic patterns: (1) CD2+3+4+8-, (2) CD2+3-4+8-, (3) CD2+3+4-8+, and (4) CD2+3+4+8+, but did not provide information concerning the intimate relationship between histologic types and immuno-phenotypes. beta-Glucuronidase reactivity, however, contributed to the distinction between helper and suppressor T-cell malignancies, suggesting its usefulness for distinguishing these two cell types and their malignant counterparts.