Hepatic Peripheral T-cell Lymphoma : A Spectrum of Liver Pathology and Clinical Correlation
WINYOU MITARNUN, M.D.*, SUPARP KIETTHUBTHEW, M.Sc.*, SUPAPORN SUWIWAT, M.Sc.*
Affiliation : * Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand.
Abstract Thirty-two patients with fever of unknown origin, weight loss, anemia, elevated serum levels of alkaline phosphatase and/or lactate dehydrogenase were evaluated. Histopathologic findings of the liver showed T-cell infiltration in the hepatic sinusoids and portal tracts. The cellular morpho- logy varied from mature lymphocyte to malignant lymphoid cells. We divided the cases into four groups on the basis of cellular atypia. Group A and group B showed mature lymphoid cell infiltration, however, only group B had multiple large areas of hepatocellular necrosis. Group C showed atypical lymphoid cell infiltration. In group D, definite malignant lymphoid cell infiltrates were demon- strated. Groups B, C, and D patients had a very poor prognosis. All of them died despite chemo- therapy. Group A patients had a better prognosis. Those who had chemotherapy achieved a complete remission. Progression to a higher group occurred in two of six patients with group B lesions and one of seven patients with group C lesions. The EBV-RNA genomes were found increasingly in the higher groups. This study supports the concept that these groups of disease represent a spectrum of peripheral T-cell proliferations.
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