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  • Title: Large B-cell lymphomas poor in B cells and rich in PD-1+ T cells can mimic T-cell lymphomas.
    Author: Ohgami RS, Zhao S, Natkunam Y.
    Journal: Am J Clin Pathol; 2014 Aug; 142(2):150-6. PubMed ID: 25015854.
    Abstract:
    OBJECTIVES: To characterize the clinicopathologic features of cases of large B-cell lymphomas, poor in B cells and densely rich in programmed cell death-1 (PD-1)+ reactive T cells, which can mimic T-cell lymphomas. METHODS: A single-institute retrospective review of cases between 2010 and 2013 was performed. RESULTS: Of 178 cases of large B-cell lymphomas, eight cases of large B-cell lymphomas poor in B cells and diffusely rich in sheets of PD-1+ T cells were identified. These cases either were initially misdiagnosed as a T-cell lymphoma or substantiated a broader differential diagnosis including a T-cell lymphoma. Five cases were T-cell histiocyte-rich large B-cell lymphomas, and three cases were diagnosed as large B-cell lymphomas rich in T cells. In three of these cases, a subset of the PD-1+ T cells showed either morphologic nuclear atypia or atypical expression of T-cell antigens on flow cytometry and/or immunohistochemistry. CONCLUSIONS: Large B-cell lymphomas poor in B cells and rich in T cells can have diffuse sheets of reactive PD-1+ T cells, some with atypical morphologic and immunophenotypic features mimicking a T-cell lymphoma. Careful assessment of the immunoarchitecture and background inflammatory and stromal cells can prevent erroneous diagnoses in such cases.
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