Aberrant antigenic expression in extranodal NK/T-cell lymphoma: a multi-parameter study from Thailand

Abstract

BackgroundExtranodal NK/T-cell lymphoma, nasal type (ENKTL) is not common worldwide, but it is the most common T- and NK-cell lymphomas in many Asian countries. Immunophenotypic profiles were studied based on limited series. The authors, therefore, studied on ENKTL according to characterize immunophenotypic profiles as well as the distribution of EBV subtype and LMP-1 gene deletion.MethodsBy using tissue microarray (TMA), immunohistochemical study and EBV encoded RNA (EBER) in situ hybridization were performed. T-cell receptor (TCR) gene rearrangement, EBV subtyping, and LMP-1 gene deletion were studied on the available cases.ResultsThere were 22 cases eligible for TMA. ENKTL were positive for CD3 (91%), CD5 (9%), CD7 (32%), CD4 (14%), CD56 (82%), TIA-1 (100%), granzyme B (95%), perforin (86%), CD45 (83%), CD30 (75%), Oct2 (25%), and IRF4/MUM1 (33%). None of them was positive for βF1, CD8, or CD57. TCR gene rearrangement was negative in all 18 tested cases. EBV was subtype A in all 15 tested cases, with 87% deleted LMP-1 gene. Cases lacking perforin expression demonstrated a significantly poorer survival outcome (p = 0.008).ConclusionsThe present study demonstrated TIA-1 and EBER as the two most sensitive markers. There were a few CD3 and/or CD56 negative cases noted. Interestingly, losses of CD45 and/or CD7 were not uncommon while Oct2 and IRF4/MUM1 could be positive in a subset of cases. Based on the present study in conjunction with the literature review, determination of PCR-based TCR gene rearrangement analysis might not be a useful technique for making diagnosis of ENKTL.

Original paper Evaluation of the role of Epstein-Barr virus in cases of nodal or extranodal T- and NK-cell lymphoma using eber in situ hybridization

“…Most reported cases are from Asia and Latin America, consistent with the higher incidence in these regions. It has been proposed that EBV-encoded RNA promotes the proliferation and transformation of T-cells [10,11]. An association between EBV and Original paper evaluatiOn Of the rOle Of epstein-Barr virus in cases Of nOdal Or extranOdal t-and nK-cell lymphOma using eBer in situ hyBridizatiOn nasal NK/T-cell lymphomas has been demonstrated [5,[11][12][13][14][15][16][17].…”

“…It has been proposed that EBV-encoded RNA promotes the proliferation and transformation of T-cells [10,11]. An association between EBV and Original paper evaluatiOn Of the rOle Of epstein-Barr virus in cases Of nOdal Or extranOdal t-and nK-cell lymphOma using eBer in situ hyBridizatiOn nasal NK/T-cell lymphomas has been demonstrated [5,[11][12][13][14][15][16][17]. Recent studies on various other subtypes of T-and NK-cell lymphomas, such as peripheral T-cell lymphoma, unspecified (PTCL, NOS) [18,19], angioimmunoblastic T-cell lymphoma (AITCL) [20], enteropathy type T-cell lymphoma (ETTCL) [21,22], and hepatosplenic T-cell lymphoma (HST-CL) [23], have also reported a possible role for EBV as an aetiopathogenetic factor.…”

Case study interpretation—new orleans: Case 3

“…NK cells CD38 CD19 CD5 CD23 CD45 2 Lambda Kappa CD19 CD10 CD20 CD45 3 CD2 CD7 CD8 CD4 CD3 CD45 4 CD56 CD13 CD3 CD34 CD14 CD45 5 7AAD CD45 6 MPO CD79a cCD3 CD34 TdT CD45 7 CD16 CD5 CD8 CD4 CD3 CD45 8 CD57 CD56 CD8 CD4 CD3 CD45 9 TCR alpha-beta TCR gamma-delta CD8 CD4 CD3 CD45 The typical immunophenotype of ENKTL is described as CD2þ, CD56þ, surface CD3À, cytoplasmic CD3eþ, granzyme Bþ, TIA-1þ, and perforin þ (2,4-6). Occasional cases also show CD7 positivity, as is seen in this specimen (2,4,6). The CD56 positivity in this case is notably weak and partial.…”

“…Normal NK cells typically coexpress CD2, CD7, and CD8 (1-5). They are negative for surface CD3 expression but express the Conversely, the antibodies used in immunohistochemical analysis of paraffin sections react positively with the cytoplasmic CD3e subunit of NK cells (3,5,6). NK cells CD38 CD19 CD5 CD23 CD45 2 Lambda Kappa CD19 CD10 CD20 CD45 3 CD2 CD7 CD8 CD4 CD3 CD45 4 CD56 CD13 CD3 CD34 CD14 CD45 5 7AAD CD45 6 MPO CD79a cCD3 CD34 TdT CD45 7 CD16 CD5 CD8 CD4 CD3 CD45 8 CD57 CD56 CD8 CD4 CD3 CD45 9 TCR alpha-beta TCR gamma-delta CD8 CD4 CD3 CD45 The typical immunophenotype of ENKTL is described as CD2þ, CD56þ, surface CD3À, cytoplasmic CD3eþ, granzyme Bþ, TIA-1þ, and perforin þ (2,4-6).…”

Identification of genuine primary pulmonary NK cell lymphoma via clinicopathologic observation and clonality assay

“…If negative, a diagnosis of NK/T cell lymphoma can be made [21]. The point has been confirmed by many NK/T cell lymphoma reported in the literature [22]. That is to say, determination of TCR gene rearrangement by PCR-based analysis may not be useful for making diagnosis of extranodal NK/T cell lymphoma.…”