Open Access Research

Aberrant antigenic expression in extranodal NK/T-cell lymphoma: a multi-parameter study from Thailand

Tawatchai Pongpruttipan1*, Tanawan Kummalue2, Anan Bedavanija3, Archrob Khuhapinant4, Koichi Ohshima5, Fumiko Arakawa5, Daisuke Niino5 and Sanya Sukpanichnant1

Author affiliations

1 Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

2 Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

3 Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

4 Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

5 Department of Pathology, Kurume University School of Medicine, Japan

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Citation and License

Diagnostic Pathology 2011, 6:79  doi:10.1186/1746-1596-6-79

Published: 25 August 2011

Abstract

Background

Extranodal NK/T-cell lymphoma, nasal type (ENKTL) is not common worldwide, but it is the most common T- and NK-cell lymphomas in many Asian countries. Immunophenotypic profiles were studied based on limited series. The authors, therefore, studied on ENKTL according to characterize immunophenotypic profiles as well as the distribution of EBV subtype and LMP-1 gene deletion.

Methods

By using tissue microarray (TMA), immunohistochemical study and EBV encoded RNA (EBER) in situ hybridization were performed. T-cell receptor (TCR) gene rearrangement, EBV subtyping, and LMP-1 gene deletion were studied on the available cases.

Results

There were 22 cases eligible for TMA. ENKTL were positive for CD3 (91%), CD5 (9%), CD7 (32%), CD4 (14%), CD56 (82%), TIA-1 (100%), granzyme B (95%), perforin (86%), CD45 (83%), CD30 (75%), Oct2 (25%), and IRF4/MUM1 (33%). None of them was positive for βF1, CD8, or CD57. TCR gene rearrangement was negative in all 18 tested cases. EBV was subtype A in all 15 tested cases, with 87% deleted LMP-1 gene. Cases lacking perforin expression demonstrated a significantly poorer survival outcome (p = 0.008).

Conclusions

The present study demonstrated TIA-1 and EBER as the two most sensitive markers. There were a few CD3 and/or CD56 negative cases noted. Interestingly, losses of CD45 and/or CD7 were not uncommon while Oct2 and IRF4/MUM1 could be positive in a subset of cases. Based on the present study in conjunction with the literature review, determination of PCR-based TCR gene rearrangement analysis might not be a useful technique for making diagnosis of ENKTL.

Keywords:
Extranodal NK/T-cell lymphoma; pathology; immunophenotype; EBV; LMP-1 gene; TCR gene rearrangement