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Original Article
- Tumor-infiltrating T lymphocytes evaluated using digital image analysis predict the prognosis of patients with diffuse large B-cell lymphoma
- Yunjoo Cho, Jiyeon Lee, Bogyeong Han, Sang Eun Yoon, Seok Jin Kim, Won Seog Kim, Junhun Cho
- J Pathol Transl Med. 2024;58(1):12-21. Published online January 10, 2024
- DOI: https://doi.org/10.4132/jptm.2023.11.02
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Abstract
PDF - Background
The implication of the presence of tumor-infiltrating T lymphocytes (TIL-T) in diffuse large B-cell lymphoma (DLBCL) is yet to be elucidated. We aimed to investigate the effect of TIL-T levels on the prognosis of patients with DLBCL.
Methods
Ninety-six patients with DLBCL were enrolled in the study. The TIL-T ratio was measured using QuPath, a digital pathology software package. The TIL-T ratio was investigated in three foci (highest, intermediate, and lowest) for each case, resulting in TIL-T–Max, TIL-T–Intermediate, and TIL-T–Min. The relationship between the TIL-T ratios and prognosis was investigated.
Results
When 19% was used as the cutoff value for TIL-T–Max, 72 (75.0%) and 24 (25.0%) patients had high and low TIL-T–Max, respectively. A high TIL-T–Max was significantly associated with lower serum lactate dehydrogenase levels (p < .001), with patient group who achieved complete remission after RCHOP therapy (p < .001), and a low-risk revised International Prognostic Index score (p < .001). Univariate analysis showed that patients with a low TIL-T–Max had a significantly worse prognosis in overall survival compared to those with a high TIL-T–Max (p < .001); this difference remained significant in a multivariate analysis with Cox proportional hazards (hazard ratio, 7.55; 95% confidence interval, 2.54 to 22.42; p < .001).
Conclusions
Patients with DLBCL with a high TIL-T–Max showed significantly better prognosis than those with a low TIL-T–Max, and the TIL-T–Max was an independent indicator of overall survival. These results suggest that evaluating TIL-T ratios using a digital pathology system is useful in predicting the prognosis of patients with DLBCL.
Brief Case Report
- Indolent CD56-Positive Clonal T-Cell Lymphoproliferative Disease of the Stomach Mimicking Lymphomatoid Gastropathy
- Mineui Hong, Won Seog Kim, Young Hyeh Ko
- Korean J Pathol. 2014;48(6):430-433. Published online December 31, 2014
- DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.430
- 8,677 View
- 66 Download
- 2 Crossref
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Citations
Citations to this article as recorded by
- Case Report: Primary Indolent Epstein-Barr Virus-Positive T-Cell Lymphoproliferative Disease Involving the Central Nervous System
Kun Wang, Jinjian Li, Xuehui Zhou, Junhui Lv, Yirong Wang, Xinwei Li
Frontiers in Surgery.2022;[Epub] CrossRef - Indolent NK cell proliferative lesion mimicking NK/T cell lymphoma in the gallbladder
Su Hyun Hwang, Joon Seong Park, Seong Hyun Jeong, Hyunee Yim, Jae Ho Han
Human Pathology: Case Reports.2016; 5: 39. CrossRef
- Case Report: Primary Indolent Epstein-Barr Virus-Positive T-Cell Lymphoproliferative Disease Involving the Central Nervous System
Original Articles
- EBV-Positive T/NK-Cell Lymphoproliferative Disease of Childhood
- Mineui Hong, Young Hyeh Ko, Keon Hee Yoo, Hong Hoe Koo, Seok Jin Kim, Won Seog Kim, Heejung Park
- Korean J Pathol. 2013;47(2):137-147. Published online April 24, 2013
- DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.137
- 13,556 View
- 113 Download
- 30 Crossref
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Abstract
PDF
Background Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH), EBV-positive systemic T-cell lymphoproliferative disease (STLPD) of childhood, and chronic active EBV (CAEBV) infection may develop after primary EBV infection. This study reviewed the clinicopathological spectrum of EBV-associated T- and natural killer (NK)-cell LPD, including STLPD and CAEBV infection, with an analysis of T-cell clonality.
Methods Clinicopathological features of seven patients with EBV-associated HLH or STLPD and 12 patients with CAEBV infection were reviewed. Immunohistochemical staining and a T-cell receptor (TCR) gene rearrangement study were performed.
Results STLPD and EBV-positive HLH showed significantly overlapping clinicopathological findings. One patient with STLPD and one patient with EBV-positive HLH demonstrated moderate to severe atypia of the infiltrating lymphocytes, whereas the remaining patients lacked significant atypia. Twelve patients had CAEBV infection, four of whom suffered mosquito-bite hypersensitivity, five showed NK lymphocytosis, and one suffered hydroa vacciniforme. Infiltrating lymphocytes were predominantly small and devoid of atypia. Hemophagocytic histiocytosis was found in seven of 11 patients. Monoclonality was detected in three (50%) of the six patients with successful TCR gene analysis.
Conclusions EBV-positive HLH and STLPD share similar clinicopathological findings and may constitute a continuous spectrum of acute EBV-associated T- or NK-cell proliferative disorders. The distinction of EBV-positive T-cell LPD from EBV-positive HLH may be difficult during routine diagnoses because of the technical limitations of clonality assessment.
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Citations
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Roberto N. Miranda, Catalina Amador, John K.C. Chan, Joan Guitart, Karen L. Rech, L. Jeffrey Medeiros, Kikkeri N. Naresh
Modern Pathology.2024; 37(8): 100512. CrossRef - Clinical epidemiology of Epstein-Barr virus-associated Lymphoproliferative Disorders (EBV-LPDs) in hospitalized children: A six-year multi-institutional study in China
Dilara Dilmurat, Xinyu Wang, Liwei Gao, Jiao Tian, Junhong Ai, Linlin Zhang, Mengjia Liu, Guoshuang Feng, Yueping Zeng, Ran Wang, Zhengde Xie
Italian Journal of Pediatrics.2024;[Epub] CrossRef - The fifth edition of the WHO‐Classification – what is new for cutaneous lymphomas?
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- Die fünfte Auflage der WHO‐Klassifikation – Was ist neu für kutane Lymphome?
- The Prognostic Subgroups as Defined by the Patterns of Epstein-Barr Virus Infection in Patients with Hodgkin Lymphoma.
- Ji Hyeon Roh, Seok Jin Kim, Won Seog Kim, Young Hyeh Ko
- Korean J Pathol. 2010;44(1):22-27.
- DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.22
- 2,768 View
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Abstract
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- BACKGROUND
The purpose of this study was to investigate the prognostic significance of the Epstein-Barr virus (EBV) infected non-neoplastic lymphocytes in patients with Hodgkin lymphoma (HL).
METHODS
Seventy-seven cases of HL were evaluated by immunohistochemical analysis and EBV-encoded RNA in situ hybridization. The cases were divided into three groups according to the EBV status. EBV was negative in 48 cases (group 1), EBV was located in the Hodgkin/Reed-Sternberg (HRS) cells, but not in the non-neoplastic lymphocytes in 20 cases (26%) (group 2) and EBV was located in both the HRS cells and the non-neoplastic lymphocytes in 9 cases (12%) (group 3).
RESULTS
The groups differed with respect to the age distribution, the clinical presentation and the prognosis. The median ages were 30 (group 1), 47.5 (group 2) and 23 years (group 3) (p = 0.011). B symptoms (p = 0.007) and the histologic subtype of mixed cellularity classical HL (p = 0.001) were more common in the EBV-positive patients than in their EBV-negative counterparts. Two patients from group 3 had associated chronic EBV infection syndrome. The five-year survival rate was 97.56% in group 1, 75.76% in group 2 and 100% in group 3 (p = 0.0178).
CONCLUSIONS
HL with EBV located in both the HRS cells and the non-neoplastic lymphocytes is a distinct prognostic subgroup that has better survival than the HL with EBV located in only the HRS cells.
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