Chromosomal translocation t(1;22)(q21;q11) in a patient with angioimmunoblastic T-cell lymphoma

Excerpt

A previously healthy 66-year-old male was referred to our hospital with sore throat and high fever (38–39 °C). CBC showed a hemoglobin level of 11.4 g/dL, a platelet count of 126 × 10⁹/L, and a WBC count of 4.54 × 10⁹/L with 66 % segmented neutrophils, 13 % lymphocytes, 19 % monocytes and 2 % eosinophils. Submandibular lymph node biopsy showed an effaced architecture with diffuse infiltration of polymorphous cells, including lymphocytes, histiocytes, and eosinophils (Fig. 1a), and extensive proliferation of thick-walled high endothelial venules (HEV) (Fig. 1b). The atypical cells were medium-to-large-sized lymphocytes with abundant pale cytoplasm and round nuclei. These were positive for CD3/CD5 and CD4 or CD8 (CD4 > CD8), and exhibited a high Ki-67 index (>70 %), while background lymphocytes were positive for CD20/CD79a and HEV cells were surrounded by CD10-positive lymphocytes (Fig. 1c). Flow cytometric analysis confirmed most cells as positive for CD2, CD3, CD4 (or CD8), CD5, and negative for CD10, CD16, CD20, CD22, CD23, CD30 and CD34. Southern blot analysis of an immunoglubulin gene (JH) and a T-cell receptor gene (Cβ1) did not detect any distinct clonal rearrangements. Given these data, he was diagnosed with angioimmunoblastic lymphoma (AITL) based on the WHO classification. G-banding analysis of chromosomes revealed a unique chromosomal translocation t(1;22)(q21;q11) in 10 of 24 metaphases (Fig. 2).

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