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Peripheral T cell lymphoma of the nasopharynx with expansion of EBV-positive B cells masquerading as an extranodal NK/T cell lymphoma, nasal type

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Abstract

Epstein-Barr virus-infected B cells are found at high frequency in peripheral T cell lymphoma. Herein, we report a case involving excessive EBV-positive B cells accompanying peripheral T cell lymphoma, not otherwise specified in the nasopharynx masquerading as nasopharyngeal extranodal NK/T cell lymphoma. A large number of Epstein-Barr virus-infected B cells infiltrate in between CD3-positive cytotoxic tumor T cells, as if EBV was infecting tumor T cells. After chemotherapy, the T cell lymphoma population decreased, but the B cell population expanded to form EBV-positive diffuse large B cell lymphoma in the tonsils and nasopharynx. At the follow-up, bone marrow biopsy exhibited infiltration of composite peripheral T cell lymphoma, not otherwise specified, and EBV-positive diffuse large B cell lymphoma. Although this condition is rare, the cell lineage of EBV-infected cells must be confirmed when diagnosing extranodal NK/T cell lymphoma to exclude the possibility of misdiagnosis by Epstein-Barr virus-infected B cells.

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References

  1. 371Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Sein H, et al. (2017) WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. IARC, Lyon

  2. Anagnostopoulos I, Hummel M, Finn T, Tiemann M, Korbjuhn P, Dimmler C, Gatter K, Dallenbach F, Parwaresch MR, Stein H (1992) Heterogeneous Epstein-Barr virus infection patterns in peripheral T-cell lymphoma of angioimmunoblastic lymphadenopathy type. Blood 80:1804–1812

    Article  CAS  Google Scholar 

  3. Ho JW, Ho FC, Chan AC, Liang RH, Srivastava G (1998) Frequent detection of Epstein-Barr virus-infected B cells in peripheral T-cell lymphomas. J Pathol 185:79–85

    Article  CAS  Google Scholar 

  4. Quintanilla-Martinez L, Fend F, Moguel LR, Spilove L, Beaty MW, Kingma DW, Raffeld M, Jaffe ES (1999) Peripheral T-cell lymphoma with Reed-Sternberg-like cells of B-cell phenotype and genotype associated with Epstein-Barr virus infection. Am J Surg Pathol 23:1233–1240

    Article  CAS  Google Scholar 

  5. Higgins JP, van de Rijn M, Jones CD, Zehnder JL, Warnke RA (2000) Peripheral T-cell lymphoma complicated by a proliferation of large B cells. Am J Clin Pathol 114:236–247

    Article  CAS  Google Scholar 

  6. Tan BT, Warnke RA, Arber DA (2006) The frequency of B- and T-cell gene rearrangements and Epstein-Barr virus in T-cell lymphomas: a comparison between angioimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma, unspecified with and without associated B-cell proliferations. J Mol Diagn 8:466–475 (quiz 527)

    Article  CAS  Google Scholar 

  7. Chihara T, Wada N, Kohara M, Matsui T, Masaya H, Maeda T, Shibayama H, Kanakura Y, Tani M, Morii E, Aozasa K (2010) Peripheral T-cell lymphoma of Lennert type complicated by monoclonal proliferation of large B-cells. Pathol Res Pract 206:185–190

    Article  Google Scholar 

  8. Skugor ND, Perić Z, Vrhovac R, Radić-Kristo D, Kardum-Skelin I, Jaksić B (2010) Diffuse large B-cell lymphoma in patient after treatment of angioimmunoblastic T-cell lymphoma. Coll Antropol 34:241–245

    PubMed  Google Scholar 

  9. Attygalle AD, Kyriakou C, Dupuis J, Grogg KL, Diss TC, Wotherspoon AC, Chuang SS, Cabeçadas J, Isaacson PG, Du MQ, Gaulard P, Dogan A (2007) Histologic evolution of angioimmunoblastic T-cell lymphoma in consecutive biopsies: clinical correlation and insights into natural history and disease progression. Am J Surg Pathol 31:1077–1088

    Article  Google Scholar 

  10. Smuk G, Illés A, Keresztes K, Kereskai L, Márton B, Nagy Z, Lacza A, Pajor L (2010) Pheno- and genotypic features of Epstein-Barr virus associated B-cell lymphoproliferations in peripheral T-cell lymphomas. Pathol Oncol Res 16:377–383

    Article  CAS  Google Scholar 

  11. Zettl A, Lee SS, Rüdiger T, Starostik P, Marino M, Kirchner T, Ott M, Müller-Hermelink HK, Ott G (2002) Epstein-Barr virus-associated B-cell lymphoproliferative disorders in angloimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma, unspecified. Am J Clin Pathol 117:368–379

    Article  Google Scholar 

  12. Reichard KK, Schwartz EJ, Higgins JP, Narasimhan B, Warnke RA, Natkunam Y (2006) CD10 expression in peripheral T-cell lymphomas complicated by a proliferation of large B-cells. Mod Pathol 19:337–343

    Article  CAS  Google Scholar 

  13. Szablewski V, Dereure O, René C, Tempier A, Durand L, Alame M, Cacheux V, Costes-Martineau V (2019) Cutaneous localization of angioimmunoblastic T-cell lymphoma may masquerade as B-cell lymphoma or classical Hodgkin lymphoma: a histologic diagnostic pitfall. J Cutan Pathol 46:102–110

    PubMed  Google Scholar 

  14. Delfau-Larue MH, de Leval L, Joly B, Plonquet A, Challine D, Parrens M, Delmer A, Salles G, Morschhauser F, Delarue R, Brice P, Bouabdallah R, Casasnovas O, Tilly H, Gaulard P, Haioun C (2012) Targeting intratumoral B cells with rituximab in addition to CHOP in angioimmunoblastic T-cell lymphoma. A clinicobiological study of the GELA. Haematologica 97:1594–1602

    Article  Google Scholar 

  15. Hu P, Ben Y, Liu J, Zheng W, Yan X, Zhang Y, Shi W (2021) Promising response to lenalidomide-combination therapy in a discordant lymphoma consisting of EBV-positive diffuse large b-cell lymphoma and angioimmunoblastic T-cell lymphoma: a case report. Onco Targets Ther 14:2489–2495

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, South Korea

    Han-Na Kim & Young Hyeh Ko

  2. Division of Hematology-Oncology, Department of Internal Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, South Korea

    Dae Sik Kim, Min Ji Jeon, Eun Sang Yu & Chul-Won Choi

Authors
  1. Han-Na Kim
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  2. Dae Sik Kim
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  3. Min Ji Jeon
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  4. Eun Sang Yu
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  5. Chul-Won Choi
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  6. Young Hyeh Ko
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Contributions

• Conceptualization: DSK, YHK

• Review of data: HNK, ESY, MJJ, CWC

• Writing—original draft: HNK, YHK.

• Writing—review and editing: DSK, CWC, YHK

The current study was approved by the institutional review board (2021GR0497) in accordance with the 1964 Helsinki declaration and its later amendments

Corresponding author

Correspondence to Young Hyeh Ko.

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Kim, HN., Kim, D.S., Jeon, M.J. et al. Peripheral T cell lymphoma of the nasopharynx with expansion of EBV-positive B cells masquerading as an extranodal NK/T cell lymphoma, nasal type. Virchows Arch 481, 125–129 (2022). https://doi.org/10.1007/s00428-021-03240-0

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  • DOI: https://doi.org/10.1007/s00428-021-03240-0

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