T-ALL presenting with i-TLP-like indolent clinical course with repeated spontaneous regressions

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2024-09-24 DOI:10.1016/j.prp.2024.155600

Yumiko Toda , Ken Ohmine , Naoki Sano , Naoya Nakamura , Atsushi Kihara , Ryutaro Tominaga , Atsuto Noguchi , Daizo Yokoyama , Shuka Furuki , Shunsuke Koyama , Rui Murahashi , Hirotomo Nakashima , Kazuki Hyodo , Shin-ichiro Kawaguchi , Kento Umino , Daisuke Minakata , Masahiro Ashizawa , Chihiro Yamamoto , Kaoru Hatano , Kazuya Sato , Yoshinobu Kanda

{"title":"T-ALL presenting with i-TLP-like indolent clinical course with repeated spontaneous regressions","authors":"Yumiko Toda , Ken Ohmine , Naoki Sano , Naoya Nakamura , Atsushi Kihara , Ryutaro Tominaga , Atsuto Noguchi , Daizo Yokoyama , Shuka Furuki , Shunsuke Koyama , Rui Murahashi , Hirotomo Nakashima , Kazuki Hyodo , Shin-ichiro Kawaguchi , Kento Umino , Daisuke Minakata , Masahiro Ashizawa , Chihiro Yamamoto , Kaoru Hatano , Kazuya Sato , Yoshinobu Kanda","doi":"10.1016/j.prp.2024.155600","DOIUrl":null,"url":null,"abstract":"<div><div>Rapidly progressing ALL, a potentially fatal disease, demands timely diagnosis and treatment. On the other hand, spontaneous remission/regression (SR) is reported in various cancers including aggressive tumors like ALL. Infection or trauma-mediated immune system activation is assumed to cause SR, with the duration in cases of ALL typically being short. Indolent T-lymphoblastic proliferation (i-TLP) exhibits the uniform proliferation of TdT-positive T-cells, despite being a non-neoplastic disease, underscoring the significance of distinguishing it from T-cell acute lymphoblastic leukemia (T-ALL). i-TLP is expected to gain wider recognition and further advancements in understanding its pathology. Here, we present the case of a 59-year-old woman with T-ALL characterized by cycles of progression and SR followed by a rapid blast proliferation. This is the first reported case of T-ALL with repeated SR for more than one year, making this case an extremely rare clinical presentation. This challenging case will enhance comprehension of T-cell tumor pathogenesis.</div></div>","PeriodicalId":19916,"journal":{"name":"Pathology, research and practice","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pathology, research and practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0344033824005119","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Rapidly progressing ALL, a potentially fatal disease, demands timely diagnosis and treatment. On the other hand, spontaneous remission/regression (SR) is reported in various cancers including aggressive tumors like ALL. Infection or trauma-mediated immune system activation is assumed to cause SR, with the duration in cases of ALL typically being short. Indolent T-lymphoblastic proliferation (i-TLP) exhibits the uniform proliferation of TdT-positive T-cells, despite being a non-neoplastic disease, underscoring the significance of distinguishing it from T-cell acute lymphoblastic leukemia (T-ALL). i-TLP is expected to gain wider recognition and further advancements in understanding its pathology. Here, we present the case of a 59-year-old woman with T-ALL characterized by cycles of progression and SR followed by a rapid blast proliferation. This is the first reported case of T-ALL with repeated SR for more than one year, making this case an extremely rare clinical presentation. This challenging case will enhance comprehension of T-cell tumor pathogenesis.

查看原文本刊更多论文

T-ALL表现为i-TLP样不活跃临床病程，反复自发消退

进展迅速的 ALL 是一种可能致命的疾病，需要及时诊断和治疗。另一方面，各种癌症包括侵袭性肿瘤（如 ALL）都有自发性缓解/消退（SR）的报道。感染或创伤介导的免疫系统激活被认为是导致自发性缓解的原因，在 ALL 病例中，自发性缓解的持续时间通常很短。惰性T淋巴细胞增生（i-TLP）表现为TdT阳性T细胞的均匀增生，尽管它是一种非肿瘤性疾病，强调了将其与T细胞急性淋巴细胞白血病（T-ALL）区分开来的重要性。在此，我们介绍了一例59岁女性T-ALL患者的病例，其特征是进展和SR周期，随后是快速的囊泡增殖。这是首例反复出现 SR 超过一年的 T-ALL 病例，临床表现极为罕见。这一具有挑战性的病例将加深对 T 细胞肿瘤发病机制的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.