Extranodal CD20-positive peripheral T-cell lymphoma presenting with adrenal and testicular masses

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  • MAKITA Masanori
    Department of Hematology and Oncology, Okayama City Hospital
  • MURAKAMI Ichiro
    Department of Clinical Laboratory Medicine, Okayama City Hospital Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • YOSHIOKA Takanori
    Department of Hematology and Oncology, Okayama City Hospital
  • TANAKA Hisaaki
    Department of Hematology and Oncology, Okayama City Hospital
  • YAMAMOTO Kazuhiko
    Department of Hematology and Oncology, Okayama City Hospital
  • IMAJO Kenji
    Department of Hematology and Oncology, Okayama City Hospital
  • TAKATA Katsuyoshi
    Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • YOSHINO Tadashi
    Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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Other Title
  • 副腎・精巣腫瘍を呈した節外性CD20陽性末梢性T細胞性リンパ腫
  • 症例報告 副腎・精巣腫瘍を呈した節外性CD20陽性末梢性T細胞性リンパ腫
  • ショウレイ ホウコク フクジン セイソウ シュヨウ オ テイシタ セツガイセイ CD20 ヨウセイ マッショウセイ Tサイボウセイ リンパ シュ

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Abstract

We report a case of extranodal CD20-positive peripheral T-cell lymphoma (PTCL). A 59-year-old man was admitted because of a right testicular mass in April 2006. CT scan revealed bilateral adrenal masses and he underwent right orchiectomy. The enlarged testis showed diffuse infiltration of large CD20-positive lymphocytes with slight CD3-positive cells. These cells were negative for CD10 and showed a high MIB-1 index. The pathological diagnosis was diffuse large B-cell lymphoma. He received R-CHOP, but developed brain involvement. He received whole brain radiotherapy following high-dose methotrexate, but he died of disease progression in August 2007. At autopsy, lymphoma cells were definitely positive for CD3 and negative for CD20. Monoclonal TCR gamma gene rearrangement was detected in the brain specimen without IgH rearrangement by PCR. The testicular tumor also showed the same clonal bands. Immunohistochemical re-evaluation of the testis showed CD20+, CD79a-, PAX5-, MUM1-, CD3 p+, CD5 p+, CD4-, CD8-, CD7 p+, granzyme B+, and TIA1+. Based on the clinical course and immunohistology, we finally diagnosed this case as extranodal PTCL-nos (not otherwise specified) with aberrant CD20 expression, which is extremely rare. The detection of gene rearrangement, plural immunohistochemical markers and knowledge of the possibility of CD20+ PTCL-nos are necessary for such cases.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 50 (5), 413-418, 2009

    The Japanese Society of Hematology

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