The vast majority of CD8+ ITLPD-GI are indolent disease, showing chronic course lasting for decades or spontaneous regression [103], transformation into a higher-grade lymphoma has also been reported in at least one case; Sharma et al. [90] reported a CD8+ ITLPD-GI that further had systemic ALK negative ALCL. Here, CD8A is linked to anaplastic large cell lymphoma.