Extranodal NK/T cell lymphoma and aggressive NK cell leukaemia: evidence for their origin on CD56+bright CD16-/+dim NK cells

Mature natural killer (NK) cell neoplasms are classified by the World Health Organization into extranodal NK/T cell lymphoma, nasal type (ENKTL) and aggressive NK cell leukaemia (ANKL). In order to propose their normal NK cell counterparts, we reviewed the literature on the phenotype of the neoplastic NK cells from five series of patients with ENKTL (n = 411) and seven series of patients with ANKL (n = 114) and compared with that of the normal and activated mature CD56+ NK cell subsets. The tumour NK cells usually express brightly the CD56 adhesion molecule and CD94 lectin type killer receptor, and have an activation-related (cytoplasmic CD3ε+, CD7−/+dim, CD45RO+, HLA-DR+) phenotype; in contrast, CD16 and killer immunoglobulin-like receptors are frequently negative, and CD57 expression is almost never observed. These phenotypic features would suggest that ENKTL and ANKL cells do represent the neoplastic counterpart of the mature CD56+bright NK cells, which undergo activation and malignant transformation after Epstein-Barr virus infection.