Peripheral T-cell lymphoma, NOS
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The diagnosis of PTCL, NOS would be made ONLY when other specific entities have been excluded.
There are four variants of PTCL, NOS:
1. Lymphoepitheliod (Lennert lymphoma) shows diffuse or more rarely interfollicular growth. Reed-Sternberg-like cells (usually EBV+) may be scattered. Majority of cases are CD8 positive.
2. Follicular T-cell lymphoma, NOS (perifollicular T-cell lymphoma, intrafollicular T-cell lymphoma, paracortical nodular T-cell lymphoma, expanded mantle zone T-cell lymphoma) usually consists of atypical clear cells forming intrafollicular aggregates (mimicking follicular lymphoma), small nodular aggregates in a background of progressively-transformed germinal centers (mimicking nodular lymphocyte-predominant Hodgkin lymphoma), or enlarged perifollicular zones/nodular aggregates surrounding hyperplastic follicles (mimicking nodal marginal zone lymphoma). Partial lymph node involvement, lack of enlarged follicular dendritic cells meshworks and lack of prominent high endothelial venules distinguish it from typical angioimmunoblastic T-cell lymphoma.
3. T-zone T-cell lymphoma-variant characterized by perifollicular growth pattern throughout the lymph nodes. Some studies suggest this variant may have a more indolent course than other PTCL, NOS.
4. Anaplastic large cell lymphoma, ALK-negative (ALCL, ALK-) involves both lymph nodes and extranodal tissue. Extranodal sites include bone, soft tissues, and skin.