Search

Niitsu N, Kohri M, Togano T, Nakamine H, Nakamura S, Iwabuchi K-i, Higashihara M. Development of hepatosplenicγδ T-cell lymphoma with pancytopenia during early pregnancy: a case report and review of the literature.Eur J Haematol 2004: 73: 367–371.© Blackwell Munksgaard 2004.Lymphomas rarely develop during pregnancy, but hepatosplenicγ δ T-cell lymphoma (HSγ δTCL) is extremely rare. We encountered a case of T-cell intracellular antigen-1 (TIA-1) positive and granzyme B-positive HSγ δTCL that developed early during the course of pregnancy. The patient was a 31-yr-old female who was referred to our hospital because of pancytopenia and splenomegaly at the time of the14th week of her gestation. Her pancytopenia and hepatosplenomegaly worsened and she became fibril at the 27th week of gestation and Cesarean section was performed at the 29th week. Histopathological examination of the spleen, which was resected 28 d after delivery for a diagnostic purpose, revealed medium to large-sized nodules composed of dense proliferation of lymphoid cells having round to oval-shaped nuclei and abundant weakly eosinophilic cytoplasm. They were CD3ℇ+, mCD3+, CD4−, CD8−, CD56+, CD79a−, T-cell receptor (TCR)-γ δ protein+, TIA-1+, and granzyme B+ by either immunohistochemistry or flow cytometry. Clonal rearrangement of TCR-γ genes without such rearrangement of TCR-δ and TCR-β genes was confirmed by Southern blot hybridization. Thus, the patient was diagnosed as having HSγ δTCL, and combination chemotherapy was initiated. She is currently in partial remission. To our knowledge, this is the first case report of HSγ δTCL that developed during pregnancy. Pathogenesis of pregnancy-associated lymphoma is not known, but it is possible that maternal immunity during pregnancy or a hormonal imbalance, such as a change in the progesterone level, induces the development of lymphoma. Pregnancy-associated lymphoma is resistant to standard chemotherapy and is associated with poor prognosis. Therefore, it is important to accumulate clinicopathologic data of such cases for the development of a treatment modality. [ABSTRACT FROM AUTHOR]

Colovic M, Pavlovic S, Kraguljac N, Colovic N, Jankovic G, Sefer D, Tosic N. Acquired amegakaryocytic thrombocytopenia associated with proliferation ofγ/δ TCR+ T-lymphocytes and a BCR-ABL (p210) fusion transcript.Eur J Haematol 2004: 73: 372–375.© Blackwell Munksgaard 2004.Acquired amegakaryocytic thrombocytopenia (AATP) in adults is a rare disorder characterized by severe thrombocytopenia and decreased or absent megakaryocytes in an otherwise normal bone marrow. We present a 44-yr-old man in whom the diagnosis of AATP was established in January 2001. Immunophenotyping of the peripheral blood lymphocytes showed a relative increase in the subpopulation of gamma/delta T-cell receptor (TCR) positive (γ/δ TCR+) and (CD4, CD8) negative T lymphocytes, and PCR suggested a monoclonal pattern of TCR gamma chain gene rearrangement. Cytogenetic examination of his bone marrow cells showed a normal male karyotype but RT-PCR analysis revealed a BCR-ABL (p210) fusion transcript. The inhibition of CFU-Mk growth mediated by the patient's T lymphocytes indicated that the pathogenic mechanism for AATP could be an immunological attack on megakaryocyte progenitors where theγ/δ TCR-positive T lymphocytes are directly involved. The case emphasizes the complex association of T-lymphocyte monoclonal proliferation and AATP. [ABSTRACT FROM AUTHOR]