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Title: Aberrant antigenic expression in extranodal NK/T-cell lymphoma: a multi-parameter study from Thailand
Authors: Tawatchai Pongpruttipan
Tanawan Kummalue
Anan Bedavanija
Archrob Khuhapinant
Koichi Ohshima
Fumiko Arakawa
Daisuke Niino
Sanya Sukpanichnant
Mahidol University. Faculty of Medicine Siriraj Hospital. Department of Pathology
Keywords: Open Access article;Extranodal NK/T-cell lymphoma;pathology;immunophenotype;EBV;LMP-1 gene;TCR gene
Issue Date: 2011
Citation: Diagnostic Pathology. Vol. 6, (2011), 79
Abstract: Background: Extranodal NK/T-cell lymphoma, nasal type (ENKTL) is not common worldwide, but it is the most common T- and NK-cell lymphomas in many Asian countries. Immunophenotypic profiles were studied based on limited series. The authors, therefore, studied on ENKTL according to characterize immunophenotypic profiles as well as the distribution of EBV subtype and LMP-1 gene deletion. Methods: By using tissue microarray (TMA), immunohistochemical study and EBV encoded RNA (EBER) in situ hybridization were performed. T-cell receptor (TCR) gene rearrangement, EBV subtyping, and LMP-1 gene deletion were studied on the available cases. Results: There were 22 cases eligible for TMA. ENKTL were positive for CD3 (91%), CD5 (9%), CD7 (32%), CD4 (14%), CD56 (82%), TIA-1 (100%), granzyme B (95%), perforin (86%), CD45 (83%), CD30 (75%), Oct2 (25%), and IRF4/ MUM1 (33%). None of them was positive for bF1, CD8, or CD57. TCR gene rearrangement was negative in all 18 tested cases. EBV was subtype A in all 15 tested cases, with 87% deleted LMP-1 gene. Cases lacking perforin expression demonstrated a significantly poorer survival outcome (p = 0.008). Conclusions: The present study demonstrated TIA-1 and EBER as the two most sensitive markers. There were a few CD3 and/or CD56 negative cases noted. Interestingly, losses of CD45 and/or CD7 were not uncommon while Oct2 and IRF4/MUM1 could be positive in a subset of cases. Based on the present study in conjunction with the literature review, determination of PCR-based TCR gene rearrangement analysis might not be a useful technique for making diagnosis of ENKTL.
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