Angioimmunoblastic T-cell lymphoma: clinical and laboratory features at diagnosis in 77 patients

Medicine (Baltimore). 2007 Sep;86(5):282-292. doi: 10.1097/MD.0b013e3181573059.

Abstract

We retrospectively analyzed 77 patients with pathologically diagnosed angioimmunoblastic T-cell lymphoma from a single city. There were 43 men and 34 women; the median age was 64.5 years (range, 30-91 yr). Average time between first symptoms of the disease and diagnosis was 3.6 months. At diagnosis, peripheral nodes were present in all but 1 patient, and were generalized in 90% of cases. Constitutional symptoms were reported in 77% of cases and spleen enlargement in 51%. A cutaneous eruption--morbilliform, urticarial, or more polymorphic--was present in 45% of patients; in one-third of them, the eruption occurred after drug administration. Other clinical manifestations included pleuritis (22%); arthralgia or arthritis (17%); ear, nose, and throat involvement (14%); central or peripheral neurologic manifestations (10%); and ascites (5%). Most patients presented with advanced disease at diagnosis (bone marrow involvement in 60% of cases). The main laboratory abnormalities were elevated lactate dehydrogenase levels (71%), inflammatory syndrome (67%), hypergammaglobulinemia (50%), anemia (51%), and lymphopenia (52%). Auto- or disimmune manifestations were reported in one-third of patients: autoimmune hemolytic anemia was present at diagnosis in 19% of patients and thrombocytopenic purpura in 7%. Documented vasculitis was described in 12% of cases. Clonality was analyzed in lymph nodes in 47 patients: T-cell and B-cell clones were found in 45 (96%) and 20 (45%) patients, respectively. Chromosomal abnormalities were identified in 62% of cases: trisomies 3, 5, 18, 19, additional X chromosome, and deletion of chromosome 7 were the most common abnormalities. The current study underlines the diversity of presenting manifestations of angioimmunoblastic T-cell lymphoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cytological Techniques
  • Diagnostic Errors
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Immunoblastic Lymphadenopathy / complications
  • Immunoblastic Lymphadenopathy / diagnosis*
  • Immunoblastic Lymphadenopathy / immunology
  • Immunoblastic Lymphadenopathy / pathology
  • Immunoblastic Lymphadenopathy / virology
  • Kaplan-Meier Estimate
  • Lymphoma, T-Cell, Peripheral / complications
  • Lymphoma, T-Cell, Peripheral / diagnosis*
  • Lymphoma, T-Cell, Peripheral / immunology
  • Lymphoma, T-Cell, Peripheral / pathology
  • Lymphoma, T-Cell, Peripheral / virology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • RNA, Viral / analysis
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Biomarkers
  • RNA, Viral