Peripheral T cell lymphoma not otherwise specified (PTCL-NOS)

Case contributed by Dr Yair Glick


Right lower abdomen-right groin swelling and fullness.

Patient Data

Age: 60 years
Gender: Female

Retrocrural, retroperitoneal, bilateral iliac and bilateral inguinal lymphadenopathy. Iliac and inguinal lymphadenopathy is pronounced on the right.

Several hypodense hepatic foci, too small to characterize.

The gallbladder has been removed.

Angiomyolipoma in right kidney measuring 18 x 42 x 25 mm, protruding towards the liver.

Case Discussion

The patient was referred to have a CT abdomen-pelvis after an ultrasound examination showed a cluster of enlarged lymph nodes in the right groin.
Following the CT, she underwent US-guided fine needle biopsy from those same inguinal lymph nodes.

Pathology report:

Macroscopic description:
4 cylinders of gray tissue 1.5-2 cm long.

Microscopic description:
Fragments of lymph node tissue showing diffuse non-atypical T cell proliferation and few scattered large cells that stained positive with CD30, MUM-1 and PAX5. CD15 stained some of them. No typical R-S cells were found. No eosinophils, plasma cells or histiocytes were seen in the background.
Following PCR test and repeat biopsy, the conclusion is that the tumor is compatible with a peripheral T cell lymphoma.

Macroscopic description:
A 1.5 cm long cylinder of tissue and several tissue samples of 0.1-0.2 cm diameter.

Microscopic description:
Fragments of lymph node showing effacement of the architecture by a diffuse infiltration of small and intermediate-sized T cells positive for CD3, CD5 and CD4/
ALK-1 stain was negative.
CD30 and CD8 stained few scattered cells.
The proliferation index (Ki-67 markers) is about 40%.

Diagnosis: The findings are compatible with peripheral T-cell lymphoma, NOS.

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