A CASE OF PLEOMORPHIC T-CELL LYMPHOMA WITH A HIGH CONTENT OF REACTIVEHISTIOCYTES PRESENTED WITH HYPEREOSINOPHILIA

A case of peripheral T-cell lymphoma classified, according to the upda ted Kiel classification, as a large pleomorphic T-cell lymphoma with a high content of reactive histiocytes and blood hypereosinophilia is r eported. Light microscopic examination revealed a diffuse effacement o f the lymph node structure by large pleomorphic lymphoma cells mixed w ith eosinophils and many histiocytes, some of them presenting discrete features of hemophagocytosis. The neoplastic cells were CD3, CD5, CD8 and HLA-DR positive but failed to show CD30 antigen. DNA molecular an alysis displayed simultaneous rearrangements of the genes coding for t he delta chain of the T-cell receptor and for the Ig heavy chain. Incr eased serum levels of angiotensin converting enzyme and ferritin were found and probably induced by the reactive histiocytes. Immunoassays ( ELISA) with antibodies directed against some cytokines and against the Tac peptide (sIL-2R) were performed. They demonstrated high serum lev els of sIL-2R and a slight increase in GM-CSF, but neither IL-5 nor IL -3. The association of blood hypereosinophilia and histiocytic hyperpl asia with a peripheral T-cell lymphoma is discussed.