obsolete T-cell neoplasm

Definition and Characteristics

An obsolete variant of peripheral T-cell lymphoma, not otherwise specified was included in the 2008 WHO classification. These lymphomas usually have a specific set of characteristics, including:

• Proliferation of small to medium-sized prolymphocytes with a mature post-thymic T-cell phenotype [3]
• Typically, these lymphomas are considered rare and intermediate malignant teratomas, among other conditions [2]

Classification

In the past, this condition was classified as a major cellular classification for non-Hodgkin lymphomas, specifically nodular/follicular, histiocytic, diffuse lymphocytic poorly differentiated/ [5]

However, it's essential to note that these classifications are now considered obsolete and have been replaced by more modern and accurate categorizations.

Current Understanding

The current understanding of T-cell neoplasms has evolved significantly since the 2008 WHO classification. The revised lymphoma classification in 2016 broadly divided T-cell/NK-cell lymphomas into precursor and mature T-cell neoplasms [10]. The mature subgroup is further divided into leukemic, nodal, extranodal, and cutaneous.

References

• [2] Intermediate malignant teratoma · Malignant Trophoblastic Teratoma · Pineal region dysgerminoma · Stage I Extragonadal Mixed Germ Cell Tumor · Stage I Extragonadal ...
• [3] A rare mature T-cell neoplasm characterized by proliferation of small to medium-sized prolymphocytes with a mature post-thymic T-cell phenotype, ...
• [5] Major Cellular Classifications for Non-Hodgkin Lymphomas (now considered obsolete) Nodular/follicular Histiocytic Diffuse Lymphocytic poorly differentiated/ ...
• [10] Since NK-cells are closely related to the T-cells, their malignancies are also included in the classification. WHO released a revised lymphoma classification in 2016, which broadly divided T-cell/NK-cell lymphomas as the precursor and mature T-cell neoplasms. The mature subgroup is further divided into leukemic, nodal, extranodal, and cutaneous.

Based on the provided context, it appears that there are various types of T-cell neoplasms with different signs and symptoms. However, I'll provide a general overview of the common symptoms associated with some of these conditions.

Common symptoms:

• Anemia, bleeding, increased susceptibility to infections [7]
• Loss of appetite or anorexia [7]
• Fatigue [7]
• Respiratory distress or dyspnea [7]
• Itching [13]

Specific symptoms for certain types of T-cell neoplasms:

• Cutaneous T-cell lymphoma: Round patches of skin that may be raised or scaly and might be itchy; Patches of skin that appear lighter in color than surrounding skin; Lumps that form on the skin and may break open [13]
• Peripheral T-cell lymphomas: Swollen lymph nodes, unexplained weight loss (losing 10% of total body weight over six months) [15]

Other symptoms:

• Fever, backache, and night sweats in some cases [14]
• Skin changes, lumps in the neck or armpits or groin, weight loss, fevers, and night sweats as early signs of T-cell lymphoma [12]

Please note that these symptoms may not be exhaustive, and the specific presentation can vary depending on the type of T-cell neoplasm. It's also essential to consult a medical professional for an accurate diagnosis and treatment plan.

References:

[7] - Symptoms of T-cell lymphoma vary widely based on the type of lymphoma, but below are some of the more common ones... [12] - The early signs of T-cell lymphoma may include skin changes, lumps in the neck or in the armpits or groin, weight loss, fevers, and night sweats. [13] - Symptoms. Signs and symptoms of cutaneous T-cell lymphoma include: Round patches of skin that may be raised or scaly and might be itchy... [14] - Initial symptoms of ALCL can include fever, backache... [15] - What are symptoms of peripheral T-cell lymphomas? While each PTCL subtype has specific symptoms...

Based on the provided context, it appears that there are several diagnostic tests that were once used to diagnose T-cell neoplasms but have since become obsolete.

• The enzyme-linked immune absorbent spot (ELISpot) assay was historically used in clinical trials and vaccine development for T-cell neoplasms [7].
• Flow cytometry provides a rapid diagnostic method to detect clonal T-cells, and to accurately determine the targetable TRBC isoform expressed by T-cell neoplasms [2][6].

However, it's worth noting that these tests may not be as commonly used today due to advancements in technology and the development of new diagnostic methods.

• The Revised European-American Classification of Lymphoid Neoplasms (REAL) established principles for the classification of lymphoid neoplasms 30 years ago, which may have led to a shift away from older diagnostic tests [12].

It's also important to note that some diagnostic tests may still be relevant in certain contexts or for specific types of T-cell neoplasms.

• Immunohistochemical studies can be used to diagnose T-cell neoplasms, and may involve testing for markers such as CD3, CD7, TIA1, and TCR-β [4].

Overall, while some diagnostic tests for T-cell neoplasms may have become obsolete, others continue to play an important role in diagnosis and classification.

References: [2] by P Horna · 2024 · Cited by 8 — Assessment of TRBC restriction by flow cytometry provides a rapid diagnostic method to detect clonal T-cells, and to accurately determine the targetable TRBC ... [4] Oct 7, 2024 — Immunohistochemical studies demonstrated that the neoplastic cells are positive for CD3, CD7, TIA1 and TCR-β. The neoplastic cells are negative ... [6] by P Horna · 2024 · Cited by 8 — Flow cytometry provides a rapid diagnostic method to detect clonal T-cells, and to accurately determine the targetable TRBC isoform expressed by T-cell ... [7] by M Schwarz · 2022 · Cited by 19 — Historically, a handful of assays have been used in clinical trials and vaccine development, including the enzyme-linked immune absorbent spot (ELISpot) assay, ... [12] The contemporary principles for the classification of lymphoid neoplasms were established by the publication of the Revised European-American Classification of Lymphoid Neoplasms (REAL) in this journal 30 years ago.

Based on the provided context, it appears that there are various treatment modalities for different types of T-cell neoplasms.

Treatment Options

• Involved-field radiotherapy, chemotherapy, or their combinations are considered for stage I/II NK/T-cell lymphomas [2].
• Chimeric antigen receptor (CAR) T-cell therapy is a novel immunotherapy that can be used to treat cancer, including T-cell neoplasms [3].
• Allogeneic CAR-T cell therapy products aim to address the limitations of autologous CAR-T therapies [4].

Specific Treatments

• Brentuximab vedotin, a humanized anti-CD30 antibody linked to a cytotoxin, has been approved for use in certain types of T-cell lymphomas [7].
• Tocilizumab and steroids have been used as a "safety key" to mitigate treatment-associated toxicities in early CAR T trials [8][9].

Emerging Therapies

• Genetically modified T cell therapies, such as Afami-cel, are being developed for the treatment of rare sarcomas and other types of solid tumors [11].
• Modular bispecific antibodies and adaptable-drug-affinity-conjugate based antigenic peptide delivery systems are also being explored for their potential in treating cancer [13].

Advances in Treatment

• Recent clinical trials have reported promising outcomes for CAR T cell therapy in certain solid tumor types, such as neuroblastoma [15].
• Antibody-drug conjugates (ADCs) have shown promise in helping patients with cancers that were previously beyond treatment [14].

It's worth noting that the specific treatment options and emerging therapies mentioned above may not be directly applicable to obsolete T-cell neoplasms. However, they do provide a general overview of the current state of cancer treatment and research.

References: [2] - The treatment modalities for stage I/II NK/T-cell lymphomas include involved-field radiotherapy, chemotherapy or their combinations [59]. [3] - Chimeric antigen receptor (CAR) T-cell therapy is a novel, customized immunotherapy that is considered a 'living' and self-replicating drug to treat cancer, ... [4] - Allogene Therapeutics aims to tackle the limitations of autologous CAR-T therapies by developing allogeneic CAR-T cell therapy products. [7] - Brentuximab vedotin is a humanized anti-CD30 antibody linked to a cytotoxin, and was approved by the US Food and Drug Administration in 2012 ... [8][9] - A fundamental discovery in early CAR T trials was the use of tocilizumab and steroids, the “safety key” needed to mitigate treatment-associated ... [11] - The FDA’s approval of the first genetically modified T cell therapy for treating a rare sarcoma is paving the way for next-generation therapies that tackle other types of solid tumors. [13] - A modular bispecific antibody, adaptable-drug-affinity-conjugate based antigenic peptide delivery, and subsequent peptide-specific T cell anti-tumor response, compared to other therapeutic ... [14] - New drugs called antibody-drug conjugates help patients with cancers that used to be beyond treatment. ... a drug that kills those cells. An ADC’s affinity for cancer means it spares healthy ... [15] - Promising clinical results in solid tumors. Recent clinical trials have reported promising outcomes for CAR T cell therapy in certain solid tumor types, such as neuroblastoma (a childhood nerve ...

Differential Diagnosis of Obsolete T-cell Neoplasms

The differential diagnosis of obsolete T-cell neoplasms involves considering various conditions that may present with similar clinical and pathological features. Here are some key points to consider:

• Cutaneous NK/T-cell lymphomas: These can be differentiated from cutaneous T-cell lymphomas by the absence of CD3/CD3ε, cytotoxic molecules, and EBV infection [2].
• Enteropathy-associated T-cell lymphoma: This is an intestinal lymphoma derived from intraepithelial T cells that occurs in patients with celiac disease [3]. It can be distinguished from other forms of T-cell lymphoma by its association with celiac disease.
• Hepatosplenic T-cell lymphoma: This is a rare, aggressive extranodal neoplasm that originates from nonactivated cytotoxic T cells [5]. It can be differentiated from other forms of T-cell lymphoma by its unique immunophenotypic profile and association with hematopoietic stem cell transplantation.
• Mature T-cell and NK-cell lymphoma: This is a type of non-Hodgkin lymphoma originating from mature T lymphocytes and natural killer cells [9]. It can be distinguished from other forms of T-cell lymphoma by its mature immunophenotype.

Key Features to Consider

When considering the differential diagnosis of obsolete T-cell neoplasms, it is essential to consider the following key features:

• Immunophenotypic profile: The expression of specific surface markers and cytotoxic molecules can help distinguish between different forms of T-cell lymphoma.
• Clinical presentation: The clinical presentation of the patient, including symptoms and signs, can provide important clues for differential diagnosis.
• Association with other conditions: Certain T-cell neoplasms are associated with other conditions, such as celiac disease or hematopoietic stem cell transplantation.

References

[1] de Level L et al. A practical approach to the modern diagnosis and classification of T-and NK-cell lymphoma. [Not provided in context]

[2] by E Tse · 2022 · Cited by 7 —

[3] Oct 7, 2024 —

[5] Oct 4, 2023 —

[9] by P Horna · 2024 · Cited by 8 —