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(80) Recurrent mutations have also been identified and well characterized in some non-Hodgkin lymphomas, such as BRAF p.V600E in hairy cell leukemia,81 myeloid differentiation factor 88 (MYD88) p.L265P in lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, (82) and RHOA p.G17V in angioimmunoblastic T-cell lymphoma. (83-85) These mutations are relatively specific, and their detection may thus aid in the diagnosis and differential diagnosis of non-Hodgkin lymphomas.
We presently report on a T-cell lymphoma, most consistent with angioimmunoblastic T-cell lymphoma (AITL) [6, 7], occurring in an 80-year-old woman's inguinal lymph node.
Soluble Fas in the serum of patients with non-Hodgkin's lymphoma: higher concentrations in angioimmunoblastic T-cell lymphoma. Am J Hematol 1998;58:334-6.
T-cell neoplasms are most commonly associated with eosinophilia, and significant eosinophilia is most frequently seen in the context of cutaneous T-cell lymphoma, adult T-cell leukemia/lymphoma, and angioimmunoblastic T-cell lymphoma. (42) The B-cell neoplasms most significantly associated with eosinophilia are classical Hodgkin lymphoma and B-lymphoblastic leukemia/lymphoma, especially B ALL with t(5; 14)(q31; q32); IGH-IL3.
In T-cell lymphomas, RS-like cells of B-cell lineage are characteristically seen in angioimmunoblastic T-cell lymphoma and, more rarely, in peripheral T-cell lymphoma, not otherwise specified.
(24) Of note, PD-1 is a marker of T-helper cells of follicle origin and is seen in other T-cell lymphomas such as angioimmunoblastic T-cell lymphoma and a subset of peripheral T-cell lymphoma, not otherwise specified.
Angioimmunoblastic T-cell lymphoma is a peripheral T-cell lymphoma of follicular helper T cells that is associated with Epstein-Barr virus and frequently includes cutaneous manifestations.
The main differential diagnosis of ATLL includes peripheral T-cell lymphoma not otherwise specified, ALCL, mycosis fungoides/Sezary syndrome, and angioimmunoblastic T-cell lymphoma. (5,29)
CD30+ large cells are present in angioimmunoblastic T-cell lymphoma (AITL) but are usually few in number and randomly scattered without perivascular accentuation or sinus involvement.
Once the T-cell phenotype has been determined, the differential diagnosis for a predominantly small, T-cell lymphoproliferative lesion with CD30 positivity includes the primary cutaneous [CD30.sup.+] lymphoproliferative disorders (primary cutaneous ALCL, lymphomatoid papulosis, and borderline lesions) (2); peripheral T-cell lymphoma, not otherwise specified; and angioimmunoblastic T-cell lymphoma. (2,3) If cutaneous lesions are not present, it is easy to rule out the primary cutaneous [CD30.sup.+] lymphoproliferative disorders.
Of the secondary or concurrent cutaneous lymphomas, angioimmunoblastic T-cell lymphoma (20%) was significantly more common in Taiwan, whereas adult T-cell leukemia/ lymphoma (29%) was more frequent in Japan (P = .02; SPSS; [chi square] test).