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Journal of Cancer Research and Clinical Oncology

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09.11.2020 | Letter to the Editor

Peripheral blood T lymphocytosis in thymoma: an insight into immunobiology

verfasst von: Shruti Mishra, Somanath Padhi, Amit Kumar Adhya, Saroj Kumar DasMajumdar, Ashutosh Pattnaik, Gaurav Chhabra

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 1/2021

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Abstract

Purpose

Peripheral blood T lymphocytosis (PBTL) is a rare, yet poorly understood manifestations of thymoma, which is postulated to be linked with autoimmune/paraneoplastic manifestations such as myasthenia gravis (MG), pure red cell aplasia (PRCA), etc.; more commonly encountered in this neoplasm.

Method

We aim to describe the flowcytometric immunophenotypic data of PBTL in a 43-year-old male; 6 months after successful completion of chemoradiotherapy (CT/RT) for a large, invasive, and metastatic type B1 thymoma; and present a comprehensive review of all such cases reported over last 42 years (N = 21) (1977–2019).

Result

A larger size of the tumors (≥ 10 cm), presence of local invasion and/or distant metastasis, and type B (cortical or lymphocyte rich) histology were more likely to be associated with PBTL. Tumors associated with MG/PRCA (N = 9/21) tend to have lower PBTL compared to those without such manifestations; and PBTL subsided following thymectomy with or without CT/RT. Immunophenotypic analysis of PB revealed a CD8 + > CD4 + mature (naïve) polyclonal T cells resembling late cortical thymocytes.

Conclusion

Thymic intratumoral microenvironment might influence occurrence PBTL that may have a pathophysiologic link to development of autoimmune manifestations. Immunophenotypic characteristics of peripheral blood lymphoid cells should be the clue for accurate characterization and to avoid a misdiagnosis of a lymphoproliferative neoplasm.

Barton AD (1997) T-cell lymphocytosis associated with lymphocyte-rich thymoma. Cancer 80:1409–1417CrossRef

Bauduer F, Archambaud F, Mazères F, Ellie E, Ducout L (2002) T-cell lymphocytosis associated with thymoma and myasthenia. Rev Med Interne 23:951–952CrossRef

Buckley C, Douek D, Newsom-Davis J, Vincent A, Willcox N (2001) Mature, long-lived CD4+ and CD8+ T cells are generated by the thymoma in myasthenia gravis. Ann Neurol 50:64–72CrossRef

Chen HK, Huang WT, Eng HL, Lu HI, Huang HY (2009) Ossifying thymoma clinically presenting with peripheral T-cell lymphocytosis. Ann Thorac Surg 88:e5-7CrossRef

Cranney A, Markman S, Lach B, Karsh J (1997) Polymyositis in a patient with thymoma and T cell lymphocytosis. J Rheumatol 24:1413–1416PubMed

Doll DC, Landreneau RJ, List AF (1991) Malignant thymoma associated with peripheral T-cell lymphocytosis. Med Pediatr Oncol 19:496–498CrossRef

de Jong D, Richel DJ, Schenkeveld C, Boerrigter L, Van’t Veer L (1997) Oligoclonal peripheral T-cell lymphocytosis as a result of aberrant T-cell development in a cortical thymoma. Diagn Mol Pathol 6:244–248CrossRef

Griffin JD, Aisenberg AC, Long JC (1978) Lymphocytic thymoma associated with T-cell lymphocytosis. Am J Med 64:1075–1079CrossRef

Hoffacker V, Schultz A, Tiesinga JJ, Gold R, Schalke B, Nix W et al (2000) Thymomas alter the T-cell subset composition in the blood: a potential mechanism for thymoma-associated autoimmune disease. Blood 96:3872–3879CrossRef

Huh HJ, Chung JW, Lee HJ, Chae SL (2015) Unusual association of CD8+ T-cell lymphocytosis with invasive thymoma. Blood Res 50:179–185CrossRef

Handa SI, Schofield KP, Sivakumaran M, Short M, Pumphrey RS (1994) Pure red cell aplasia associated with malignant thymoma, myasthenia gravis, polyclonal large granular lymphocytosis and clonal thymic T cell expansion. J Clin Pathol 47:676–679CrossRef

Medeiros LJ, Bhagat SK, Naylor P, Fowler D, Jaffe ES, Stetler-Stevenson M (1993) Malignant thymoma associated with T-cell lymphocytosis. A case report with immunophenotypic and gene rearrangement analysis. Arch Pathol Lab Med 117:279–283PubMed

Morales M, Trujillo M, Maeso MC, Piris MA (2007) Thymoma and progressive T-cell lymphocytosis. Ann Oncol 18:603–604CrossRef

Otton SH, Standen GR, Ormerod IE (2000) T-cell lymphocytosis associated with polymyositis, myasthenia gravis and thymoma. Clin Lab Haematol 22:307–308CrossRef

Puljiz Z, Karin Z, Bratanic A, Kresak VG, Pulzij M, Forempoher G et al (2013) Late distant metastases of malignant thymoma associated with peripheral T-cell lymphocytosis. Pathol Int 63:516–518CrossRef

Pedraza MA (1977) Thymoma, immunological and ultrastructural classification. Cancer 39:1455–1461CrossRef

Shachor Y, Radnay J, Bernheim J, Rozenszajn A, Bruderman I, Klajman A, Steiner ZP (1988) Malignant thymoma with peripheral blood lymphocytosis. Cancer 61:1222–1227CrossRef

Smith GP, Perkins SL, Segal GH, Kjeldsberg CR (1994) T-cell lymphocytosis associated with invasive thymomas. Am J Clin Pathol 102:447–453CrossRef

Soler J, Estivill X, Ayats R, Brunet S, Pujol-Moix N (1985) Chronic T-cell lymphocytosis associated with pure red cell aplasia, thymoma, and hypogammaglobulinemia. Br J Haematol 61:582–584CrossRef

Ströbel P, Helmreich M, Menioudakis G, Lewin SR, Rüdiger T, Bauer A et al (2002) Paraneoplastic myasthenia gravis correlates with generation of mature naive CD4+ T cells in thymomas. Blood 100:159–166CrossRef

Tabata R, Tabata C, Yamamoto N, Shibuya S, Yasumizu R, Kojima M (2018) Progressive peripheral CD8+ T lymphocytosis complicated by pure red cell aplasia following immunosuppressive therapy for thymoma-associated myasthenia gravis. Int Immunopharmacol 63:14–18CrossRef

Tamaoki J, Chiyotani A, Nagai A, Konno K (1997) Invasive thymoma with CD4+CD8+double–positive T cell lymphocytosis. Respiration 64:176–178CrossRef

Yokoi K, Miyazawa N, Kano Y, Akutsu M, Mori K, Tominaga K, Imura G (1997) Tumor lysis syndrome in invasive thymoma with peripheral blood T-cell lymphocytosis. Am J Clin Oncol 20:86–89CrossRef

Zhao L, Zhou X, Li Z, Liu Y (2016) Bone metastasis of malignant thymomas associated with peripheral T-cell lymphocytosis. BMC Surg 16:58CrossRef

Titel: Peripheral blood T lymphocytosis in thymoma: an insight into immunobiology
verfasst von: Shruti Mishra
Somanath Padhi
Amit Kumar Adhya
Saroj Kumar DasMajumdar
Ashutosh Pattnaik
Gaurav Chhabra
Publikationsdatum: 09.11.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 1/2021
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-020-03440-2

Springer Medizin

Peripheral blood T lymphocytosis in thymoma: an insight into immunobiology