Hodgkin's and non-Hodgkin's lymphoma: spectrum of morphologic and immunophenotypic overlap.
Immunoperoxidase markers are useful and often essential in distinguishing among lymphocyte-predominant Hodgkin's lymphoma, T-cell-rich B-cell lymphoma, and lymphocyte-rich classic Hodgkin's lymphoma. However, it is becoming increasingly clear that these "entities" are closely related clonal B-lineage neoplasms that may intertransform and/or coexist. We hypothesized that, just as there are cases with morphologic overlap, there would also be immunophenotypic overlap that would be found when a series of such cases is studied in detail. Eight cases of lymphocyte predominant Hodgkin's lymphoma, eight cases of lymphocyte-rich classic Hodgkin's lymphoma, seven cases of T-cell-rich B-cell lymphoma, and four cases of large B-cell lymphoma with focal features of T-cell-rich B-cell lymphoma were examined by the immunoperoxidase technique for expression of CD3, CD15, CD30, CD20, CD57, epithelial membrane antigen, and Epstein-Barr virus latent membrane protein (EBV LMP). All eight of the lymphocyte-predominant Hodgkin's lymphoma cases had CD20+ lymphocytic and histiocytic cells and CD57+ rosettes; however, in two cases, occasional lymphocytic and histiocytic cells were also weakly positive for CD15, CD30, and EBV LMP. Among the eight lymphocyte-rich classic Hodgkin's lymphoma cases, CD15+ Reed-Sternberg (R-S) cells were found in seven; however, in three of these cases rare rosettes of CD57+ cells surrounded the R-S or lacunar cells. In one case of large B-cell lymphoma the malignant cells resembled R-S cells and were CD20+, EBV LMP+, CD30+, CD15-, and surrounded by rosettes of CD57+ T cells. The majority of the cases exhibited the "expected" immunophenotypic patterns; however, the exceptional cases that were found serve to confirm the interrelationship among these clonal B-lineage neoplasms.
Elgin
J
J
Department of Pathology, Russell Hospital, Alexander City, AL, USA.
Phillips
J G
JG
Reddy
V V
VV
Gibbs
P O
PO
Listinsky
C M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000032:analysis; D000956:Antigens, Viral / Q000032:analysis; D001402:B-Lymphocytes / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D006689:Hodgkin Disease / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000473:pathology*; D014763:Viral Matrix Proteins / Q000032:analysis
D000911:Antibodies, Monoclonal; D000956:Antigens, Viral; D014408:Biomarkers, Tumor; C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins