Differential diagnosis between nodular lymphocyte-predominant Hodgkin lymphoma and T-cell/histiocyte-rich B-cell lymphoma.
- Author:
Yan-hui LIU
1
;
Heng-guo ZHUANG
;
Han-liang LIN
;
Qiu-liang WU
;
Dong-lan LUO
;
Li LI
;
Xin-lan LUO
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Antigens, CD20; metabolism; CD57 Antigens; metabolism; Child; Diagnosis, Differential; Female; Gene Rearrangement, B-Lymphocyte, Heavy Chain; Hodgkin Disease; genetics; immunology; pathology; Humans; Immunophenotyping; Lymph Nodes; pathology; Lymphoma, Large B-Cell, Diffuse; genetics; immunology; pathology; Male; Middle Aged; Poly(A)-Binding Proteins; metabolism; Retrospective Studies; T-Cell Intracellular Antigen-1; T-Lymphocytes; immunology; metabolism; pathology
- From: Chinese Journal of Oncology 2006;28(8):594-598
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study the differential diagnosis between nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) and T-cell/histiocyte-rich B-cell lymphoma (TCRBCL).
METHODS15 cases of NLPHL and 16 cases of TCRBCL were studied on both morphology and immunophenotype according to the WHO classification of lymphoid neoplasms. SP-immunohistochemical staining were performed on paraffin sections. In situ hybridization for EBER1/2 and gene rearrangement of immunoglobulin heavy chain (IgH) were carried out in 3 cases of NLPHL and 4 cases of TCRBCL, respectively.
RESULTSHistologically, a few atypical large cells scattered in a background of small lymphocytes with or without histiocytes were a common finding in both NLPHL and TCRBCL. Of NLPHL, nodular pathern predominated in 11 cases, diffuse patterns without nodules in 3 cases and one case showed nodular and diffuse pattern intermixed with a increased number of large cells. 14 cases of TCRBCL showed diffuse pattern. One case with micronodular pattern involving the splenic white pulp. One case showed a combination of nodules of NLPHL, diffuse areas of TCRBCL and a sheet of large cells of diffuse large B-cell lymphoma (DLBCL) within the same lymph node biopsy specimen. Immunophenotypically, the large cells showed and CD20, CD79a, bcl-6 and EMA positive, and CD15, CD30, CD3, CD45RO and LMP-1 negative. In NLPHL, small B cells and CD57 positive cells were common, whereas in TCRBCL, TIA-1 positive cytotoxic cells and histiocytes dominated, small B cells were scarce or absent. EBER1/2 were negative and gene rearrangement of IgH was found in all tested 3 cases of NLPHL and 4 cases of TCRBCL, respectively.
CONCLUSIONThere are some morphologic and immunophenotypic resemblance between NLPHL and TCRBCL. A combination of the morphological characteristics and the reactivity of the background cells for CD57 and TIA-1 seem to reliably discriminate between the entities and should therefore help to increase the interobserver reproducibility of diagnosis in the gray zone around Hodgkin lymphomas.
