Angiocentric lymphoma initially presenting as lymph node infarction: report of an autopsy case with immunophenotypic and genotypic studies.:report of an autopsy case with immunophenotypic and genotypic studies
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We report an autopsy case of angiocentric lymphoma initially manifested as lymph node infarction. The second biopsy obtained from the other lymph node showed a diffuse proliferation of various-sized lymphoid cells with cytologic atypia. Cellular infiltration to vascular walls accompanied by irregular necrotic areas was observed. Immunohistological study of the lymph node expressed the phenotype (CD3+CD8+CD4±), consistent with that of peripheral T-cell lymphoma, except that some large lymphoid cells were positive for B-cll specific antibody L26.The autopsy showed extensive lymphoma cell infiltration of the liver, spleen, kidneys, lungs, gastrointestinal tract, nasopharynx, and lymph nodes. Of interest, the angiocentric and angioinvasive nature of the lymphoma cell infiltration was evident, and necrosis of tissues was accompanied by the infiltration. These features are characteristic of angiocentric lymphoma, and retrospective studies suggest that the lymph node infarction was caused by angiocentric immunoproliferative lesions introduced by Jaffe in 1984.Southern blot analysis of DNA extracted from the lymph nodes of the second biopsy and of the autopsy showed germline configurations for T-cell receptor (TcR) β-chain, δ-chain and immunoglobulin heavy chain genes. Only TcR γ-chain exhibited multiple faint rearrangement bands, but this is compatible with polyclonal T-cell proliferation. The results obtained through our studies, in addition to the previously reported cases, suggest that certain types of peripheral T-cell lymphoma may lack clonal rearrangements of TcR genes.
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