T-cell lymphoma
Meaning of T-cell lymphoma: A group of lymph system cancers arising from the immune cells that direct and carry out attacks rather than make antibodies.
Definition of T-cell lymphoma
T-cell lymphoma is any of a group of cancers that begin in T lymphocytes, the immune cells that coordinate defenses and destroy infected cells directly. These cancers are much less common than those arising from B cells and are generally harder to treat. They may involve lymph nodes, the skin, the blood or organs such as the bowel, depending on the subtype.
How does it differ from the more common lymphomas?
Lymphomas are grouped first by which lymphocyte they came from. B cells make antibodies; T cells patrol tissue, direct other immune cells and kill infected cells themselves. Most lymphoma arises from B cells, and treatment for those has been transformed by antibodies that target a B cell marker. No equivalent has emerged for T cells, partly because a drug that removes T cells removes much of the defense against infection at the same time. That is a large part of why B cell lymphoma outcomes have improved faster.
What are the main types?
| Type | Where it shows itself |
|---|---|
| Peripheral T-cell lymphoma, not otherwise specified | Lymph nodes, often widespread at diagnosis |
| Cutaneous types such as mycosis fungoides | Persistent scaly patches and plaques on the skin |
| Anaplastic large cell lymphoma | Nodes and skin, with distinct subgroups by protein marker |
| Angioimmunoblastic | Nodes with fever, rash and autoimmune features |
| Adult T-cell leukemia and lymphoma | Blood, skin and bone, linked to the HTLV-1 virus |
How is it recognized?
A lymph node or skin biopsy is examined for cell appearance and for surface proteins, and genetic testing of the T cell receptor gene shows whether the cells all descend from a single clone, which distinguishes cancer from a vigorous immune reaction. This matters because the skin forms can look identical to eczema or psoriasis for years before the diagnosis becomes clear. Scans and marrow sampling establish extent. As a group these are classified within non-Hodgkin lymphoma, and staging follows the same system used across that family.
What influences outcome?
Subtype matters more than almost anything else. Skin limited disease can run an indolent course over decades with treatment directed at the skin alone. Widespread nodal types tend to behave aggressively and respond less durably to standard chemotherapy than their B cell counterparts, so stem cell transplantation and clinical trial enrollment feature prominently in their management.
Used in a sentence
Immunophenotyping of the node biopsy established a diagnosis of peripheral T-cell lymphoma.
Good to know
T-cell lymphomas are far less common than B cell types and lack an equivalent targeted antibody, and the skin limited forms can be mistaken for eczema or psoriasis for years.