Histiocyte-rich, T-cell-rich B-cell lymphoma: a distinct diffuse large B-cell lymphoma subtype showing characteristic morphologic and immunophenotypic features.
OBJECTIVE
The clinicopathological features of histiocyte-rich, T-cell-rich B-cell lymphoma (HRTR-BCL) were first recognized in 1992. In this study, 60 cases of HRTR-BCL were analysed in order to provide a detailed morphological and immunophenotypical profile of the disorder.


RESULTS
HRTR-BCL is easily distinguished from other B-cell lymphomas rich in stromal T-cells by (i) a diffuse or vaguely nodular growth pattern, (ii) the presence of a minority population of CD15-, CD20+ large neoplastic B-cells, (iii) a prominent stromal component composed of both T-cells and non-epithelioid histiocytes, and (iv) the scarcity of small reactive B-cells. These criteria also enable a reliable distinction from lymphocyte-rich classical Hodgkin's lymphoma (CHL), from lymphocyte-predominant Hodgkin's lymphoma (LPHL), paragranuloma type and from peripheral T-cell lymphoma. Based on the morphology of the neoplastic cells and on their frequent bcl-6 immunoreactivity, we speculate that HRTR-BCL may be derived from a progenitor cell of germinal centre origin.


CONCLUSIONS
HRTR-BCL presents characteristic clinical features, affecting predominantly middle-aged men who present with advanced stage disease and are at high risk of treatment failure. Considering these distinctive clinicopathological features, recognizing HRTR-BCL as a lymphoma entity may be justified.
Achten
Ruth
R
Department of Morphology and Molecular Pathology, University Hospitals K. U. Leuven, Minderbroedersstraat 12, B-3000 Leuven, Belgium. Ruth.Achten@uz.kuleuven.ac.be
Verhoef
G
G
Vanuytsel
L
L
De Wolf-Peeters
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D019938:Cyclin D1 / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006644:Histiocytes / Q000737:chemistry / Q000473:pathology*; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D016256:Lewis X Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000737:chemistry / Q000145:classification / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000473:pathology; D013601:T-Lymphocytes / Q000737:chemistry / Q000473:pathology*
D018951:Antigens, CD20; D014408:Biomarkers, Tumor; D016256:Lewis X Antigen; D019938:Cyclin D1