Conflict of interest: Nothing to report
Reply to Tan et al†
Version of Record online: 11 SEP 2012
Copyright © 2012 Wiley Periodicals, Inc.
American Journal of Hematology
Volume 87, Issue 11, page E130, November 2012
How to Cite
Kwong, Y.-L. (2012), Reply to Tan et al. Am. J. Hematol., 87: E130. doi: 10.1002/ajh.23326
- Issue online: 23 OCT 2012
- Version of Record online: 11 SEP 2012
- Accepted manuscript online: 22 AUG 2012 01:06AM EST
- Manuscript Accepted: 10 AUG 2012
- Manuscript Received: 7 AUG 2012
We appreciate the concerns of Tan et al. In our report of enteropathy associated T-cell lymphomas (EATL) , we included three cases where Epstein–Barr virus (EBV) infection of the lymphoma cells was demonstrable. We were indeed mindful that cytotoxic T-cell lymphomas with EBV infection could also be classified as natural killer/T-cell (NK/T-cell) lymphomas, nasal type; according to World Health Organization classification . However, none of these cases showed histopathological features suggestive of NK/T-cell lymphomas. EBV was detected in the majority of lymphoma cells. Clonal T-cell receptor gene rearrangement was found, which according to our experience was unusual in NK/T-cell lymphomas in our population. Their presentations were also indistinguishable from other cases of EATL. Therefore, we felt that these cases should not be preemptively classified as NK/T-cell lymphoma. The inclusion of these cases in our series might prompt other investigators to examine carefully if a small fraction of EATL cases might be EBV-positive. This approach will enrich our understanding of intestinal T-cell lymphomas in a population where celiac disease is not found. Finally, we also believe that pathological entities are best defined by relevant clinical syndromes than the presence or absence of a viral infection.
- 1Type II enteropathy-associated T-cell lymphoma: A multicenter analysis from the Asia Lymphoma Study Group. Am J Hematol 2012; 87: 663–668., , , et al.
- 2Extranodal NK/T-cell lymphoma, nasal type. In: Swerdlow SH,Campo E,Harris NL, et al., editors. WHO Classification of Tumours of the Haematopoietic and Lymphoid Tissues, 4th ed. Lyon: IARC; 2008. pp 285–288., , , .
Yok-Lam Kwong*, * Department of Medicine, Queen Mary Hospital, Hong Kong.