Sex steroid receptors in Hodgkin's disease

A case report of a dramatic therapeutic response of Hodgkin's disease (HD) to diethylstilbestrol (DES) in a man who was being treated for concurrent p rostate cancer suggested that there also may be a role for sex steroids in the pathogenesis of HD (1). High levels of estrogen receptors (ER) comparab le to those seen in breast carcinoma cells were detected in that patient's Hodgkin's biopsy specimen. In order to determine whether this patient was u nique or whether sex steroid receptors commonly are present in HD specimens , we examined expression of ER and progesterone receptors (PR) in diagnosti c tissue from pediatric (n=14) and adult (n=41) patients with HD using immu nohistochemistry. None of the 55 samples expressed PR. 16/55 (29%) demonstr ated weak nuclear ER positivity, which was confined to germinal center and occasional mantle zone lymphocytes and was comparable to that seen in non-m alignant control lymph nodes. 4/55 (7.3%) samples exhibited moderate positi vity in Reed Sternberg cells, which in one case was nuclear. ER commonly ar e expressed weakly in some HD tumors unrelated to clinical stage or patient sex but are generally limited to germinal center and mantle zone lymphocyt es. A rare patient displays moderate cytoplasmic or nuclear ER in Reed-Ster nberg cells.