Pathologic and clinical features of Hodgkin lymphoma--like posttransplant lymphoproliferative disease.
Because of its rarity, pathologic and clinical features of Hodgkin lymphoma-like posttransplant lymphoproliferative disorder (HL-like PTLD) are not well understood, and it is unclear whether its biological behavior is more closely related to classical Hodgkin disease or to monomorphic B-cell PTLD. The authors compared 6 cases of HL-like PTLD with 5 cases of monomorphic B-cell PTLD for differences in histology, immunophenotype, and clinical behavior. Histologically, all cases of HL-like PTLD resembled classical HL with typical Reed-Sternberg (RS) cells and a cellular background mimicking mixed cellularity subtype. CD45 was absent on RS-like cells, but the expression pattern of B-cell-associated markers Oct-2 and BOB.1 resembled monomorphic B-cell PTLD. Whereas Epstein-Barr virus early RNA expression is normally restricted to RS cells of classical HL, it was expressed in both RS-like cells and background lymphocytes in HL-like PTLD. Although all patients diagnosed with monomorphic B-cell PTLD show no evidence of disease following treatment, half of the patients with HL-like PTLD relapsed or died, indicating a more aggressive clinical behavior. The findings suggest that HL-like PTLD represents a distinct clinicopathologic entity with an aggressive clinical course.
Krishnamurthy
Smita
S
Department of Pathology and Immunology, Washington University Medical Center, St Louis, Missouri 63110, USA.
Hassan
Anjum
A
Frater
John L
JL
Paessler
Michele E
ME
Kreisel
Friederike H
FH
D000293:Adolescent; D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006689:Hodgkin Disease / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications; D016601:RNA-Binding Proteins / Q000378:metabolism; D016539:Reed-Sternberg Cells / Q000378:metabolism / Q000473:pathology; D012269:Ribosomal Proteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D007166:Immunosuppressive Agents; D016601:RNA-Binding Proteins; D012269:Ribosomal Proteins; C067169:RPL22 protein, human