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Recurrences in Nodal T-Cell Lymphoma
Changes in Histologic Appearance and Immunophenotype Over the Course of Disease

Dan Jones MD, PhD, David J. Weissmann MD, PhD, Madeleine D. Kraus MD, Robert P. Hasserjian MD, Aliakbar Shahsafaei MS, David M. Dorfman MD, PhD
DOI: http://dx.doi.org/10.1093/ajcp/114.3.438 438-447 First published online: 1 September 2000


We examined the patterns of relapse or persistence in 37 cases of nodal peripheral T-cell lymphoma (PTCL) to address the morphologic and immunophenotypic findings. Relapses were documented in lymph node (25 cases) and/or a variety of extranodal sites at a mean of 21 months after presentation; several cases recurred as late as 13 years. Persistent bone marrow involvement was a feature of angioimmunoblastic lymphoma (AIL) and histiocyte-rich and small-cell tumors. Relapses in anaplastic tumors often involved unusual extranodal sites. The majority of relapsed PTCLs retained a similar histologic appearance, pattern of nodal involvement, and immunophenotype. Histologic progression, as assessed by increased numbers of large cells, was seen in 3 cases of AIL, in 1 case with an initial small cell morphologic appearance, and in 2 cases of PTCL with an initial mixed small and large cell appearance. Immunostains for T-cell activation markers showed increased immunoreactive cells in 5 of the 6 cases, whereas increased numbers of p53-positive tumor cells were noted in 3 of the 6 cases. The discrete large cell transformation occasionally seen in B-cell lymphoma and extranodal T-cell lymphoma was not observed in these cases.

Key Words:
  • Non-Hodgkin lymphoma
  • Angioimmunoblastic lymphoma
  • Anaplastic large cell lymphoma