T-cell variant of classical Hodgkin's lymphoma with nodal and cutaneous manifestations demonstrated by single-cell polymerase chain reaction.
The atypical cells of CD30(+) cutaneous lymphoproliferative disorders (CD30CLD) are commonly of T-cell origin and frequently have a similar morphology as Hodgkin or Reed-Sternberg cells of Hodgkin's lymphoma (HL). HL is one of the tumors associated with CD30CLD. Although most studies support a B-cell derivation of the tumor cells in HL, recently a few cases of classical HL with T-cell genotype have been reported. We report a patient who presented with CD30CLD whose lymph nodes showed classical HL of mixed cellularity subtype at presentation. By single-cell PCR, the same clonal gene rearrangements of the T cell receptor-beta gene locus could be assigned to the CD30(+) and CD15(+) cells of both skin and lymph node. In a lymph node biopsy specimen taken in relapse after several courses of chemotherapy, the CD30(+) tumor cells were abundant. The T cell-derived tumor cells displayed aberrant expression of the Pax-5 gene in all specimens. A common clonal origin of both CD30CLD and HL of the lymph node in the patient presented here suggests that HL with T-cell genotype exists in association with CD30CLD as well as in sporadic cases and may share clonal origin with the skin tumor.
Willenbrock
Klaus
K
Senckenberg Institute of Pathology, University of Frankfurt, Frankfurt am Main, Germany. Willenbrock@em.uni-frankfurt.de
Ichinohasama
Ryo
R
Kadin
Marshall E
ME
Miura
Ikuo
I
Terui
Tadashi
T
Meguro
Kuniaki
K
Fukuhara
Osamu
O
DeCoteau
John F
JF
Hansmann
Martin-Leo
ML
D004268:DNA-Binding Proteins / Q000032:analysis; D005260:Female; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006689:Hodgkin Disease / Q000145:classification / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000032:analysis*; D016256:Lewis X Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000473:pathology*; D008875:Middle Aged; D051757:PAX5 Transcription Factor; D016133:Polymerase Chain Reaction / Q000379:methods*; D012871:Skin Diseases / Q000473:pathology*; D014157:Transcription Factors / Q000032:analysis
D004268:DNA-Binding Proteins; D017730:Ki-1 Antigen; D016256:Lewis X Antigen; D051757:PAX5 Transcription Factor; C497281:PAX5 protein, human; D014157:Transcription Factors