Study of the immunohistochemistry and T cell clonality of enteropathy- associated T cell lymphoma

• Published in: The American journal of pathology Vol. 146; no. 2; pp. 509 - 519
• Main Authors: Murray, A, Cuevas, EC, Jones, DB, Wright, DH
• Format: Journal Article
• Language: English
• Published: Bethesda, MD ASIP 01-02-1995; American Society for Investigative Pathology
• Subjects: Adult; Aged; Aged, 80 and over; Antigens, CD - analysis; Biological and medical sciences; Celiac Disease - complications; Celiac Disease - pathology; DNA, Neoplasm - genetics; Female; Gene Rearrangement, T-Lymphocyte - genetics; Hematologic and hematopoietic diseases; Humans; Intestinal Neoplasms - etiology; Intestinal Neoplasms - genetics; Intestinal Neoplasms - immunology; Intestinal Neoplasms - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, T-Cell - etiology; Lymphoma, T-Cell - genetics; Lymphoma, T-Cell - immunology; Lymphoma, T-Cell - pathology; Male; Medical sciences; Middle Aged; Human; Immunohistochemistry; Pathogenesis; Malignant hemopathy; Non Hodgkin lymphoma; Small intestine; Polymerase chain reaction; Pathology; Concomitant disease; Intestinal malabsorption; Lymphoproliferative syndrome; Digestive diseases; Intestinal disease; Molecular biology
• ISSN: 0002-9440; 1525-2191

Specimens from 23 patients with enteropathy-associated T cell lymphoma were studied by immunohistochemistry after antigen retrieval. Specimens from 14 of these patients were investigated for the presence of clonal T cell gene rearrangements in both the tumor and the adjacent enteropathic intestine by the polymerase chain reaction. Primers for T cell receptor beta and gamma genes were used in a combination that permits the identification of approximately 90% of T cell receptor rearrangements. Clonal rearrangements of the T cell receptor were found in 13 of the 14 tumors studied. Specimens of enteropathic bowel resected with the tumor, but showing no morphological or immunohistochemical evidence of tumor involvement, showed clonal T cell receptor gene rearrangements in 11 cases. In 10 of these, the amplified DNA was of the same molecular weight in the enteropathic bowel as in the corresponding tumor. In 2 cases, sequencing the polymerase chain reaction product showed identical T cell receptor gene rearrangements in the tumor and in the adjacent intestine. Uniform staining for p53 was seen in 22 of the 23 tumors. In 9 of 19 cases studied, collections of small lymphocytes in the enteropathic bowel expressed p53. In all but one of these specimens, a clonal rearrangement of the T cell receptor genes was identified. We interpret these findings as support for the concept that enteropathy-associated T cell lymphoma arises on a background of gluten-sensitive enteropathy with evolution of neoplastic T cell clones from the reactive T cell population present in the enteropathic bowel.