title: Cytotoxic molecule-positive classical Hodgkin's lymphoma: a clinicopathological comparison with cytotoxic molecule-positive peripheral T-cell lymphoma of not otherwise specified type.
abstract: BACKGROUND
  Classical Hodgkin's lymphoma is characterized by Hodgkin and Reed Sternberg cells, which are of B-cell origin in many cases. We recently highlighted the adverse prognostic significance of cytotoxic molecule expression in patients with classical Hodgkin's lymphoma. However, the clinical characteristics of cytotoxic molecule-positive classical Hodgkin's lymphoma remain controversial.
  
  
  METHODS
  We investigated the clinicopathological profiles of 32 patients with cytotoxic molecule-positive Hodgkin's lymphoma, comprising 23 with nodular sclerosis and 9 with mixed cellularity, and compared these profiles with those of 55 patients with cytotoxic molecule-positive nodal peripheral T-cell lymphoma, not otherwise specified and 439 patients with cytotoxic molecule-negative Hodgkin's lymphoma.
  
  
  RESULTS
  The patients with cytotoxic molecule-positive Hodgkin's lymphoma consisted of 20 men and 12 women with a median age of 50 years (range, 19 to 81). All these patients had lymphadenopathy at presentation, and 14 showed mediastinal involvement. Physical findings included hepatomegaly and splenomegaly in six patients each. Four patients had a bulky mass, and nine showed stage IV disease. The tumor cells of patients with cytotoxic molecule-positive Hodgkin's lymphoma had a prototypic immunophenotype of CD15(+) CD30(+) CD45RO(-) fascin(+), with positivity for Epstein-Barr virus in 39% of cases. All patients were negative for Pax5. In comparison with patients with cytotoxic molecule-positive nodal peripheral T-cell lymphomas, not otherwise specified, patients with cytotoxic-positive Hodgkin's lymphoma had relatively mild clinical symptoms, similar to those of patients with cytotoxic molecule-negative Hodgkin's lymphoma. Regarding prognosis, the survival of patients with cytotoxic molecule-positive Hodgkin's lymphoma was worse than that of patients with cytotoxic molecule-negative Hodgkin's lymphoma (P = 0.0003) but better than that of patients with cytotoxic molecule-positive peripheral T-cell lymphomas, not otherwise specified (P = 0.002).
  
  
  CONCLUSIONS
  Cytotoxic molecule-positive Hodgkin's lymphoma is characterized by an unfavorable prognosis, even if its clinicopathological features are within the boundaries of classical Hodgkin's lymphoma. More effective chemotherapy for cytotoxic molecule-positive Hodgkin's lymphoma is clearly required.
authors.affiliation: Department of Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan. naasano@med.nagoya-u.ac.jp
authors.forename: Naoko
authors.initials: N
authors.lastname: Asano
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Tamaru
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
authors.forename: Nozomi
authors.initials: N
authors.lastname: Niitsu
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsukamoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hirabayashi
authors.forename: Koji
authors.initials: K
authors.lastname: Izutsu
authors.forename: Masafumi
authors.initials: M
authors.lastname: Taniwaki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D006689:Hodgkin Disease / Q000378:metabolism* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D016399:Lymphoma, T-Cell / Q000378:metabolism* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor