Splenic Involvement by Peripheral T-cell and NK-cell Neoplasms

In contrast to B-cell lymphomas, the literature on the splenic pathology of peripheral T-cell and NK-cell lymphomas is limited. Several different patterns of splenic involvement can be observed in peripheral T-cell and NK-cell lymphomas: 1) solitary or multiple fleshy nodule, which is seen predominantly in tumors rich in large cells; 2) diffuse red pulp involvement, which is the commonest pattern; 3) colonization of periarteriolar shealth; and 4) patchy haphazard involvement. However, the miliary small nodule pattern commonly observed in low-grade B-cell lymphomas is practically never seen. In hepatosplenic T-cell lymphoma and T-cell large granular lymphocyte leukemia, the pattern of splenic involvement is rather stereotyped, with diffuse red pulp infiltration and preservation of the sinus/pulp cord architecture, and without formation of nodules. The pattern of involvement is variable from case to case in peripheral T-cell lymphoma unspecified, and there can be associated prominent hemophagocytosis or a masking component of epithelioid granulomas. Aggressive NK cell leukemia and extranodal NK/T cell lymphoma show predominatly red pulp involvement, although the tumor cell density can vary from field to field; blood vessel walls are commonly infiltrated and there can be areas of necrosis.