Hodgkin's disease with an intrasinusoidal pattern of infiltration - A report of two cases

The histological distinction between Hodgkin's disease (HD) and anaplastic large cell lymphoma (ALCL) may be difficult but is important as the two con ditions have different clinical behaviours, prognoses and responses to ther apy. Morphological appearances that have been emphasised as favouring the d iagnosis of ALCL rather than HD include the identification of neoplastic ce lls permeating sinusoidal spaces. We document two cases of Hodgkin's diseas e with classical morphological and immunohistochemical features of nodular- sclerosis subtype (HDNS) but with striking sinusoidal involvement by neopla stic cells. In each case, the CD30 positive/CD15 positive immunophenotype o f the neoplastic cells was characteristic of HD without expression of any o f the other antigens normally associated with ALCL. HD is generally conside red to be a morphological diagnosis and. in those laboratories in which it is not possible to use wide panels of antibodies for the confirmation of th e diagnosis, the identification of sinusoidal infiltration by the neoplasti c cells in HD may lead to the mistaken impression of ALCL.