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Liver and intrahepatic bile ducts - tumor

Leukemia / lymphoma

Hepatosplenic gamma-delta T cell lymphoma

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.


● Rare, < 100 cases reported
● Usually young or middle aged men with massive hepatosplenomegaly and elevated liver function tests, B symptoms (fever, night sweats, weight loss) but no significant nodal involvement, pancytopenia, aggressive clinical course (median survival 8 months)
● Refractory to chemotherapy
● Often occurs after solid organ transplantation, but reduction in immunosuppression does not affect clinical course in Crohn’s disease patients

Case reports

● 45 year old man with leukemic disease 5 years after renal transplant and continous immunosuppression with cyclosporine A and prednisolone (Hum Pathol 2002;33:253)

Micro description

● Sinusoidal lymphoid infiltrate of liver (3+ lymphocytes fill / expand sinusoid), spleen and bone marrow by medium sized lymphocytes with condensed chromatin and rim of eosinophilic cytoplasm

Positive stains

● CD2, CD3, CD7, CD16 (50%), CD43, CD45RO, CD56, TIA1, reticulin and T cell receptor gamma-delta chains

Negative stains

● CD4, CD5, CD8, CD57, T cell receptor alpha-beta chain and EBV

Molecular description

● Isochromosome 7q (i7q10 in 2/3), trisomy 8 and Y-

Differential diagnosis

CMV and EBV have sinusoidal infiltrate but less bulky portal inflammation, hepatocyte ballooning, lobular disarray, higher levels of transaminases
Drug related hepatitis

End of Liver and intrahepatic bile ducts - tumor > Leukemia / lymphoma > Hepatosplenic gamma-delta T cell lymphoma

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