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When Vasculitis Is Not Vasculitis: A Case Report in Which Dynamic Immunophenotyping Revealed Hidden Angioimmunoblastic T-cell Lymphoma

I-YAO LIN, JENG-WEI LU, YI-JUNG HO, SHAN-WEN LUI, TING-YU HSIEH, WUN-LONG JHENG and FENG-CHENG LIU
In Vivo May 2026, 40 (3) 1842-1851; DOI: https://doi.org/10.21873/invivo.14338

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Cutaneous vasculitic rash and interval development of abdominal pathology on serial computed tomography. (A) Erythematous and purpuric non-blanchable maculopapular rash over the lower limbs upon admission. (B) Abdominal computed tomography on September 9, 2025, demonstrating panniculitis, ascites, hepatomegaly, splenomegaly (17.6 cm), and periaortic lymphadenopathy. (C) Abdominal computed tomography on January 23, 2025, showing no significant abnormalities.

  • Figure 2.
    Figure 2.

    Reduction of exhaustion markers in cytotoxic T-cell subsets and dynamic changes in regulatory T cells following splenectomy. Longitudinal changes in regulatory T cell percentages and exhaustion markers in T cytotoxic cells. The panels show decreases in the percentages of programmed cell death protein 1 (PD-1)+ and T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3)+ T cytotoxic cells (Tc) across the central memory (CM), effector, and effector memory (EM) subsets after the splenectomy. HC: Healthy controls; data obtained from healthy volunteers.

  • Figure 3.
    Figure 3.

    Decreased expression of senescence markers on central memory (CM) and effector T-cell subsets after splenectomy. Longitudinal changes in senescence markers in T helper cells and T cytotoxic cells. The panels demonstrate decreases in the percentages of fas cell surface death receptor (Fas)+ and killer cell lectin-like receptor G1 (KLRG)+ cells among CM and effector T cytotoxic (Tc) cells, as well as CM and effector T helper (Th) cells, following splenectomy. HC: Healthy controls; data obtained from healthy volunteers.

  • Figure 4.
    Figure 4.
    Figure 4.

    Dynamic alterations in B-cell phenotypes and activation markers following splenectomy. (A) Longitudinal changes in B cell phenotypes. Among marginal zone and naïve B cell subsets, cluster of differentiation 21 (CD21) expression decreases after splenectomy and subsequently increases during follow-up. In contrast, fas cell surface death receptor (Fas) and human leukocyte antigen-DR isotype (HLA-DR) expression increase post-splenectomy but decline during follow-up. (B) Similar trends are observed across all examined B cell subsets. HC: Healthy controls; data obtained from healthy volunteers.

  • Figure 5.
    Figure 5.

    Progressive upregulation of T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) and programmed cell death protein 1 (PD-1) on Naïve T helper (Th) and cytotoxic T cells during follow-up. Longitudinal changes in exhaustion markers in naïve Th cells and T cytotoxic cells. Panels demonstrate that the percentages of naïve Th cells Tim-3+, naïve Th cells PD-1+, naïve T cytotoxic cells (Tc) Tim-3+, naïve Tc cells PD-1+ increase during the follow-up period. HC: Healthy controls; data obtained from healthy volunteers.

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When Vasculitis Is Not Vasculitis: A Case Report in Which Dynamic Immunophenotyping Revealed Hidden Angioimmunoblastic T-cell Lymphoma
I-YAO LIN, JENG-WEI LU, YI-JUNG HO, SHAN-WEN LUI, TING-YU HSIEH, WUN-LONG JHENG, FENG-CHENG LIU
In Vivo May 2026, 40 (3) 1842-1851; DOI: 10.21873/invivo.14338
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