Angioimmunoblastic T-cell lymphoma in bone marrow: a morphologic and immunophenotypic study

Faisal A. Khokhar, William D. Payne, Sameer S. Talwalkar, Jeffrey L. Jorgensen, Carlos E. Bueso-Ramos, L. Jeffrey Medeiros, Francisco Vega

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Angioimmunoblastic T-cell lymphoma is known to frequently involve bone marrow. However, the histologic and immunophenotypic features of angioimmunoblastic T-cell lymphoma at this site are poorly defined. We assessed 27 bone marrow specimens involved by angioimmunoblastic T-cell lymphoma from 20 patients. Histologically, bone marrow involvement was predominantly multifocal (74%) and exhibited a nodular pattern (78%), often associated with other patterns. Using immunohistochemistry, programed death-1 and CD10 were expressed by atypical lymphocytes in 17 (85%) of 20 and 5 (18.5%) of 27 specimens, respectively. CXCL13 was not expressed by atypical lymphocytes in all cases but did stain stromal cells consistent with follicular dendritic cells in 1 case. BCL-6 as a single antibody was difficult to interpret because many normal bone marrow cells are dimly positive, but BCL-6/CD3 dual staining highlighted BCL-6+ T-cells in all cases assessed. Antibodies specific for CD21 and CD35 did not highlight follicular dendritic cells in any biopsy specimens. Flow cytometry immunophenotyping revealed a CD3+CD10+ T-cell population in 2 (25%) of 8 cases assessed. We conclude that the recognition and classification of angioimmunoblastic T-cell lymphoma in bone marrow are made difficult by the uncommon expression of CD10 (25%), rarity of follicular dendritic cells, and lack of CXCL13 expression at this site. This is most likely attributable to the very different microenvironment of the bone marrow relative to lymph nodes and, in particular, the absence of follicles in bone marrow. By contrast, programed death-1 immunohistochemical staining and double labeling using antibodies specific for BCL-6 and CD3 were helpful in appreciating the follicular T-helper cell immunophenotype of angioimmunoblastic T-cell lymphoma.

Original languageEnglish (US)
Pages (from-to)79-87
Number of pages9
JournalHuman Pathology
Volume41
Issue number1
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

    Fingerprint

Keywords

  • Angioimmunoblastic T-cell lymphoma
  • BCL-6
  • Bone marrow
  • CD10
  • CXCL13
  • Flow cytometric immunophenotyping
  • Immunohistochemistry

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Khokhar, F. A., Payne, W. D., Talwalkar, S. S., Jorgensen, J. L., Bueso-Ramos, C. E., Medeiros, L. J., & Vega, F. (2010). Angioimmunoblastic T-cell lymphoma in bone marrow: a morphologic and immunophenotypic study. Human Pathology, 41(1), 79-87. https://doi.org/10.1016/j.humpath.2009.06.016