Progressive transformation of germinal centers and nodular lymphocyte predominance Hodgkin's disease: A comparative immunohistochemical study

Phuong L. Nguyen, Judith A. Ferry, Nancy L. Harris

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

To determine whether there might be immunophenotypic differences between nodular lymphocyte predominance Hodgkin's disease (NLPHD) and progressive transformation 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 wits 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 florid 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 showed an irregular, 'broken-up' pattern with CD20 and CD45RA, and there were prominent T cell rosettes around the CD20+ large cells in all nodules. Rosettes 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 between NLPHD and PTGC with respect to staining for CD30 or CD21. Three of the eight patients with florid PTGC and a few T cell rosettes had had persistent or recurrent lymphadenopathy: NLPHD developed in I of these patients 13 years later. We conclude that a combination of pan-B and pan-T antigens can be a useful adjunct to morphology in distinguishing NLPHD from PTGC. In approximately 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 patients may be appropriate.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume23
Issue number1
DOIs
StatePublished - Jan 1999
Externally publishedYes

Fingerprint

Hodgkin Disease
Lymphocytes
T-Lymphocytes
Progressive Transformation of Germinal Centers
Staining and Labeling
Wit and Humor
Viral Tumor Antigens
Paraffin
Differential Diagnosis
Immunohistochemistry

Keywords

  • Hodgkin's disease
  • Immunohistochemistry
  • Nodular lymphocyte pre-dominance Hodgkin's disease
  • Progressive transformation of germinal center

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Progressive transformation of germinal centers and nodular lymphocyte predominance Hodgkin's disease : A comparative immunohistochemical study. / Nguyen, Phuong L.; Ferry, Judith A.; Harris, Nancy L.

In: American Journal of Surgical Pathology, Vol. 23, No. 1, 01.1999, p. 27-33.

Research output: Contribution to journalArticle

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abstract = "To determine whether there might be immunophenotypic differences between nodular lymphocyte predominance Hodgkin's disease (NLPHD) and progressive transformation 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 wits 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 florid 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 showed an irregular, 'broken-up' pattern with CD20 and CD45RA, and there were prominent T cell rosettes around the CD20+ large cells in all nodules. Rosettes 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 between NLPHD and PTGC with respect to staining for CD30 or CD21. Three of the eight patients with florid PTGC and a few T cell rosettes had had persistent or recurrent lymphadenopathy: NLPHD developed in I of these patients 13 years later. We conclude that a combination of pan-B and pan-T antigens can be a useful adjunct to morphology in distinguishing NLPHD from PTGC. In approximately 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 patients may be appropriate.",
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