Clinical and pathological analysis of indolent T-cell lymphoproliferative disease of the gastrointestinal tract

作者：Dan Yuan, Na Liang, Dongyue Wang, Jinjing Wang, Congwei Jia · 发表于：Frontiers in Immunology · 年份：2025 · DOI：10.3389/fimmu.2025.1530149 · 被引用次数：5 · 研究领域：Lymphoma Diagnosis and Treatment、T-cell and Retrovirus Studies、Viral-associated cancers and disorders

Objective: This study aimed to investigate the clinicopathological features of indolent T-cell lymphoproliferative disease of the gastrointestinal tract (ITLPD-GI) and to improve its diagnostic and therapeutic approaches. Methods: A retrospective analysis was conducted on eight ITLPD-GI patients treated between January 2018 and January 2024. Clinical data, pathological features, immunophenotypes, molecular testing results, and follow-up records were reviewed. Results: Clinical characteristics: Male-to-female ratio 3:5; mean age at onset 42 years. Symptoms: Predominantly diarrhea and abdominal pain. Endoscopic findings: Erosions, multiple shallow ulcers, and small polypoid lesions. Pathological features: Histology: Atrophy of gastric/intestinal glands with diffuse infiltration of small lymphocytes (round/irregular nuclei, dense chromatin) in the lamina propria; rare mitoses; absence of angioinvasion or necrosis. Notably, two cases showed prominent plasma cell infiltration in the superficial mucosa. Immunophenotype: Pan-T-cell markers positive (5/8); CD4-/CD8+ (5/8), CD4+/CD8+ (2/8), CD4+/CD8- (1/8); aberrant CD20 expression (2/8); low Ki-67 index. TCR rearrangement: Monoclonal in all four tested cases. Treatment and prognosis: Supportive therapy (five cases): Dietary modification, immunosuppression, immunomodulation, and anti-infective agents. Symptoms resolved in one case but persisted in four. Targeted therapy (one CD20+ case): Rituximab added, with no improvement after 14 m...