2 cases of T-cell rich B-cell lymphoma subsequent to autoimmune disease.

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We report here 2 cases of T-cell rich B-cell lymphoma (TCRBCL) subsequent to autoimmune disease. Case 1 is a 45 years old woman with rheumatoid arthritis and case 2 is a 58 years old woman with Sjögren's syndrome. Both of them developed non-Hodgkin's lymphoma. Histological examination revealed that many small T-lymphocytes and scattered large B-lymphocytoid cells, immunoblast like cells were proliferated interfollicularly with small follicules in case 1 and definitive diagnosis was not accordant with among several pathologists. Large and medium sized lymphoid cells were proliferated intermingled with small lymphocytes, macrophages and myoepithelial island in parotid in case 2 and malignant lymphoma was questioned in clinically.As for case 1, rearrangement of T-cell receptor β gene was not detected but that of immunoglobulin JH gene using Southern blotting. DNA of case 2 were extracted from paraffin embedded material and amplified by PCR. Monoclonality of B-cell lineage was demonstrated. So we came to conclude these cases were non-Hodgkin's lymphoma of B-cell phenotype and classified TCRBCL. There is a hypothesis of "biological interaction" about mechanism of onset of TCRBCL and in these 2 cases, TCRBCL was subsequent to autoimmune disease, in which immunological inbalance may present. Immunological abnormality may be involved closely in onset of certain malignant lymphoma.
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