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Aggressive Subcutaneous Panniculitis-Like CD30+ Peripheral T-Cell Lymphoma with Diffuse EBER Expression.

Amandeep Aneja1, Raghava LevakaVeera2, Viren Patel1

  • 1Department of Pathology, Temple University Hospital, 3401 N Broad Street, Philadelphia, PA 19140, USA.

Case Reports in Hematology
|August 22, 2014
PubMed
Summary

This study details a rare T-cell lymphoma case with CD30 and Epstein-Barr virus (EBV) co-expression. The findings highlight a challenging differential diagnosis between PTCL, NOS and ALK-negative ALCL.

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Area of Science:

  • Oncology
  • Immunology
  • Pathology

Background:

  • CD30 expression and ALK1 negativity in T-cell lymphomas can present diagnostic challenges.
  • Anaplastic Large Cell Lymphoma (ALCL), ALK-negative, is typically Epstein-Barr virus (EBV)-negative.
  • Peripheral T-cell Lymphoma (PTCL), NOS, encompasses a heterogeneous group of T-cell malignancies.

Purpose of the Study:

  • To describe a rare case of T-cell lymphoma with co-expression of CD30 and EBV.
  • To discuss the diagnostic implications of this rare presentation.
  • To highlight the differential diagnosis between PTCL, NOS and ALK-negative ALCL.

Main Methods:

  • Morphological and immunophenotypic analysis of neoplastic cells.
  • Immunohistochemistry for CD3, CD2, CD30, LCA, CD20, PAX5, CD56, ALK1, and EBER.
  • T-cell receptor (TCR) gene rearrangement analysis by PCR.
  • Assessment of proliferation index.

Main Results:

  • The T-cell lymphoma exhibited anaplastic large cell morphology with scattered hallmark cells.
  • Neoplastic cells showed uniform CD30 and EBER expression.
  • Cells were positive for CD3, CD2, and CD30; negative for LCA, CD20, PAX5, CD56, ALK1.
  • Positive TCR gene rearrangement and a proliferation index near 100% were observed.
  • The patient presented with subcutaneous involvement and a rapidly progressive course.

Conclusions:

  • This case represents a rare association between EBV and CD30-positive T-cell lymphoma.
  • Morphological and immunophenotypic findings mimicked both PTCL, NOS and ALK-negative ALCL.
  • The presence of EBV in this context requires careful consideration in the differential diagnosis.