Pl. Nguyen et al., Progressive transformation of germinal centers and nodular lymphocyte predominance Hodgkin's disease - A comparative immunohistochemical study, AM J SURG P, 23(1), 1999, pp. 27-33
Citations number
20
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
To determine whether there might be immunophenotypic differences between no
dular lymphocyte predominance Hodgkin's disease (NLPHD) and progressive tra
nsformation of germinal centers (PTGC) to aid in the differential diagnosis
, we compared 16 cases of NLPHD with 13 cases of florid PTGC and 2 cases of
focal PTGC. Paraffin-section immunohistochemistry was performed for CD20,
CD45RA, CD45RO, CD3, CD43, CD57, EMA, CD30, and CD21. All PTGC cases showed
well-circumscribed nodules of confluent sheets of CD20+CD45RA+ small cells
. T cells were scattered singly or in small groups. In 5 patients with flor
id PTGC, the T cells in some of the nodules formed rings around a few large
transformed lymphocytes. In contrast, the nodules in all NLPHD cases showe
d an irregular, "broken-up" pattern with CD20 and CD45RA, and there were pr
ominent T cell rosettes around the CD20+ large cells in all nodules. Rosett
es of CD57+ cells and staining of large cells for EMA were seen in 3 and 2
cases of NLPHD, respectively, but not in PTGC. There were no differences be
tween NLPHD and PTGC with respect to staining for CD30 or CD21. Three of th
e eight patients with florid PTGC and a few T cell rosettes had had persist
ent or recurrent lymphadenopathy; NLPHD developed in 1 of these patients 13
years later. We conclude that a combination of pan-B and pan-T antigens ca
n be a useful adjunct to morphology in distinguishing NLPHD from PTGC. In a
pproximately one-third of florid PTGC cases, T cell rosettes may be present
, but they are notably fewer than those in NLPHD. Close follow-up of such p
atients may be appropriate.