How I Diagnose Angioimmunoblastic T-Cell Lymphoma

Yi Xie, MD, PhD; Elaine S. Jaffe, MD


Am J Clin Pathol. 2021;156(1):1-14. 

In This Article

Diagnostic Challenges

Accurate diagnosis of AITL can be difficult due to its diverse clinical symptoms and wide histopathologic changes, which can mimic a variety of benign and malignant lymphoid proliferations Table 3. One of the common challenges is identifying "early" AITL cases (type I pattern) and separating them from reactive paracortical hyperplasia. In addition, B-cell proliferations that accompany AITL may also pose a challenge in the differential diagnosis. In particular, the presence of HRS-like cells may lead to misdiagnosis as CHL. Distinguishing AITL from other nodal PTCL-TFHs can be particularly difficult, although it currently has no impact on clinical management. Given the complex heterogeneous nature of AITL, a multiparameter approach with careful integration of clinical history, morphology, and immunophenotypic findings, supplemented by molecular/genetic analysis as necessary, is essential to make an accurate diagnosis. In the next section, we discuss some of the most common questions about the diagnosis and differential diagnosis of AITL.