The Early Diagnostic Dilemma in Angioimmunoblastic T Cell Lymphoma with Excessive Plasma Cells Proliferation

Table 1

Ancillary examination results of BM, ascites, and LN.

	BM	Ascites	LN
Morphology	PCs were account for ∼48.5%, showing large size, round, or irregular nucleus	Large amount of PCs with immature appearance, some of PC are double nuclei; few lymphocytes scattered	Proliferation of FDCs and HEVs with lots of PCs infiltration and part of lymphocytes (40–50%) were EBV positive
PC (by MFC)	Polyclonal (∼34.7%)	Polyclonal (∼36.3%)	Polyclonal (∼18.3%)
B lymphocytes (by MFC)	Cytoplasm light chain negative (∼0.24%)	Large B cells with surface and cytoplasm light chain negative (∼4.9%)	Normal polyclonal B cells (∼13.6%)
Abnormal T cells (by MFC)	Negative	Negative	Abnormal T cells account for ∼15.3% with CD2+, CD7−, sCD3+, CD4+, and CD10-
Karyotype	Negative	Not done	46, XY [19]/48, XY; +3, +10/44, XY, +3, −9, −10, −15 [1]
Receptor gene rearrangement	Negative	Negative	TCR gene rearrangement positive and IgH rearrangement negative
NGS	Not done	Not done	TET2 gene C1193 W mutation, G1275 R mutation, and IDH2 gene R172k mutation.

BM, bone marrow; LN, lymph node; PC, plasma cell; MFC, multiparameter flow cytometry; FDCs, follicular dendritic cells; HEVs, high endothelial venules; EBV, Epstein–Barr virus; NGS, next-generation sequencing; TCR, T cell receptor; IgH, immunoglobulin heavy chain; TET2, tet methylcytosine dioxygenase 2; IDH2, isocitrate dehydrogenase 2.