Primary gastric apoptosis-rich T-cell lymphoma co-expressing CD4, CD8, andcytotoxic molecules

In contrast to primary gastric lymphomas of B-cell type, little is known ab out primary gastric T-cell lymphomas. We describe three cases with remarkab ly similar features: diffuse growth, epitheliotropism, medium too large cel l size, high apoptotic rates, and a CD3+, CD4+, CD8+, CD45RO+ immunophenoty pe. Clonal TCR gamma gene rearrangement was shown in two cases. Epstein-Bar r virus infection was excluded in two cases. Taking advantage of fresh-froz en material, we analyzed two cases further, revealing CD5-, CD16+, CD56-, C D57-, CD25+, CD30+, CD103 (alpha E beta 7)+, bcl-2 protein+, CD95+, CD95 li gand(L)-. CD95L, however, was detected in histiocytic and fibroblastoid by stander cells. The lymphomas expressed granzyme B, perforin, and the TIA-1 antigen in various combinations. All three cases had a very unfavorable cli nical course characterized by local recurrence and/or dissemination to othe r epithelial sites, leading to death within 6-12 months after the initial d iagnosis despite surgery and aggressive antineoplastic treatment. These dat a suggest a novel variant of peripheral T-cell lymphoma operationally chara cterized as primary gastric, apoptosis-rich, CD103+, EBV-, T-cell lymphoma co-expressing CD4, CD8, CD16 and cytotoxic molecules.