Epstein-Barr virus clonality and plasmacytosis in a patient with atypical angioimmunoblastic T cell lymphoma

Okuyama, Shuhei; Terada, Taichi; Kumagai, Hiroaki; Tsumanuma, Riko; Omoto, Eijiro; Ueki, Tetsuya; Yanagawa, Naoki; Maeda, Keiko; Tajima, Katsushi

doi:10.1007/s00277-017-3189-1

Cited by 4 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reactive polyclonal plasmacytosis occurs in various situations, such as viral infection (EBV, parvovirus B19, and hepatitis), autoimmune diseases, and serum sickness. Excessive plasmacytosis in bone marrow (BM) and peripheral blood (PB) associated with hypergammaglobulinemia in AITL have been reported in the past few years [16][17][18][19][20][21]. Early diagnosis can be very challenging.…”

Section: Introductionmentioning

confidence: 99%

The Early Diagnostic Dilemma in Angioimmunoblastic T Cell Lymphoma with Excessive Plasma Cells Proliferation

Wang

Mao

Liu

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

Background. Angioimmunoblastic T cell lymphoma (AITL) is an aggressive Epstein–Barr virus-associated T cell lymphoma. Clinical syndromes of AITL are not confined to fever and lymphadenopathy, and patients may initially present with polyclonal plasma cell proliferation, which may obscure the underlying disease of AITL, delaying diagnosis. Case Presentation. Here, we report two AITL patients with excessive plasma cell proliferation in the bone marrow, peripheral blood, and ascites even mimicking plasma cell leukemia. Both of them had poor endings. Conclusions. Our report emphasizes the complexity of the clinical manifestations of AITL, which aims to increase the alertness of physicians and improve the rate of early diagnosis. Integrated diagnostic approaches such as histopathology, flow cytometry, cytogenetics, and molecular biology are essential for accurate diagnosis and precise therapy.

show abstract

Section: Introductionmentioning

confidence: 99%

The Early Diagnostic Dilemma in Angioimmunoblastic T Cell Lymphoma with Excessive Plasma Cells Proliferation

Wang

Mao

Liu

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

show abstract

“…The polyclonal nature of the plasmacytosis, however, ultimately suggests a reactive etiology, such a viral infection (EBV, parvovirus B19, hepatitis), autoimmune disease (rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome), or serum sickness (6, 7). EBV has an established association with numerous B-cell and T cell lymphoproliferative neoplasms, including AITL (8, 9). Here we report the case of a patient with AITL who presented with marked peripheral blood polyclonal plasmacytosis, polyclonal hypergammaglobulinemia, and high levels of pEBVd, suggestive of EBV reactivation.…”

Section: Introductionmentioning

confidence: 99%

Extreme Peripheral Blood Plasmacytosis Mimicking Plasma Cell Leukemia as a Presenting Feature of Angioimmunoblastic T-Cell Lymphoma (AITL)

et al. 2019

View full text Add to dashboard Cite

Angioimmunoblastic T-cell lymphoma (AITL) is one of four major subtypes of nodal peripheral T cell lymphoma, characterized by its cell of origin, the follicular helper T-cell (T FH ). Patients typically present with prominent constitutional (B) symptoms, generalized lymphadenopathy, hepatosplenomegaly, cytopenias, and rash. Here we present a case of a 62-year-old male with progressive cervical adenopathy, fevers and weight loss presenting with extreme polyclonal plasmacytosis and high plasma EBV viral load. While the initial presentation appeared to mimic plasma cell leukemia or severe infection, lymph node biopsy and bone marrow biopsy confirmed a diagnosis of AITL. This case highlights the heterogeneity of the clinical presentation of AITL to enable physicians to more promptly recognize, diagnose and initiate treatment.

show abstract

“…However, atypical florid plasmacytosis-mimicking plasma cell leukemia is rare. Most reported cases represent polyclonal plasmacytosis with exuberant plasma cell proliferation in the bone marrow or PB [23][24][25][26]. Concurrent clonal plasma cell proliferation in lymph nodes may also occur, although the potential mechanisms involved in neoplastic transformation have not been clarified [27,28].…”

Section: Discussionmentioning

confidence: 99%

Flow Cytometry Analysis Reveals a Wide Cytologic and Immunophenotypic Spectrum of Peripheral B Lymphocytes in Angioimmunoblastic T-Cell Lymphoma

Liu¹,

Liao²,

Weng³

et al. 2022

Pathobiology

View full text Add to dashboard Cite

Introduction: Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive T-cell lymphoma commonly associated with B-cell dysregulation. Correlations involving B-cell dysregulation and clinicopathological features remain unclear. Methods: We prospectively collected blood samples from 11 AITL patients and 17 healthy controls. The percentages of B-cell subpopulations and lymphocytes with IL-21 production were assessed using flow cytometry. Peripheral blood lymphocyte morphology was evaluated microscopically. Results: Six of 11 (54.5%) patients presented with polyclonal hypergammaglobulinemia. Three of 11 (27.3%) tumor biopsies showed monoclonal immunoglobulin gene rearrangement. The patients exhibited significantly lower levels of naive (p < 0.001) and class-switched (p < 0.001) B cells than controls. The percentages of IgD−CD27− B cells (p = 0.007) and antibody-secreting cells (ASCs) (p = 0.001) were increased. Blood smears revealed atypical lymphocytes and immature plasma cells with morphological diversity. In comparison to normal controls, IL-21 production significantly increased in CD4+ (p < 0.001) and CD8+ (p = 0.020) T cells. B-cell clonality, RHOA G17V mutation, and the presence of sheets of clear cells and immature/mature plasma cells in lymph nodes were significantly associated with percentages of class-switched B cells and ASCs. The patients with circulating EBV DNA had a lower percentage of naive B cells (p = 0.009). Conclusions: Our results demonstrated a wide spectrum of peripheral B-cell morphologies and immunophenotypes of peripheral B cells in AITL. These findings correspond to dysregulated B-cell immunity and heterogeneous clinicopathological features.

show abstract

Epstein-Barr virus clonality and plasmacytosis in a patient with atypical angioimmunoblastic T cell lymphoma

Cited by 4 publications

References 8 publications

The Early Diagnostic Dilemma in Angioimmunoblastic T Cell Lymphoma with Excessive Plasma Cells Proliferation

The Early Diagnostic Dilemma in Angioimmunoblastic T Cell Lymphoma with Excessive Plasma Cells Proliferation

Extreme Peripheral Blood Plasmacytosis Mimicking Plasma Cell Leukemia as a Presenting Feature of Angioimmunoblastic T-Cell Lymphoma (AITL)

Flow Cytometry Analysis Reveals a Wide Cytologic and Immunophenotypic Spectrum of Peripheral B Lymphocytes in Angioimmunoblastic T-Cell Lymphoma

Contact Info

Product

Resources

About