Nodal peripheral T-cell lymphomas and, in particular, their lymphoepithelioid (Lennert’s) variant are often derived from CD8⁺ cytotoxic T-cells

Nodal peripheral T-cell lymphomas are not well understood, and most of them are classified in the “not otherwise specified group” (PTCL-NOS). Data on their normal cellular derivation are ambiguous. Most peripheral T-cell lymphomas are composed of tumor cells and a (sometimes dominant) reactive background, which also includes resting and activated T-lymphocytes. We defined the phenotype of the tumor cells in 101 PTCL-NOS based on their cytological atypia and using immunohistochemical double stains on paraffin sections with CD4/Ki67 and CD8/Ki67. The results were correlated to clinical presentation and outcome. Lineage could be defined in 98 cases (97%). Tumor cells were CD4⁺ in 43 cases and CD8⁺ in 38. These presented at a younger age but a higher clinical stage compared with the CD4⁺ lymphomas. In 15 cases, the atypical cells were CD4⁻CD8⁻; two cases were CD4⁺CD8⁺. Of 17 lymphoepithelioid (Lennert’s) lymphomas, 15 expressed CD8, one each was CD4⁺ and CD4⁻CD8⁻.