title: Pediatric Hodgkin lymphoma in a South Indian regional cancer center: its immunomorphology, tumor-associated macrophages, and association with Epstein-Barr virus.
abstract: Pediatric Hodgkin lymphoma (HL) comprises approximately a fifth of all patients with HL in India. Seventy-four cases of pediatric classical Hodgkin Lymphoma (cHL) from a regional cancer center in southern India were analyzed on a tissue microarray (TMA) for the stage of B-cell differentiation of the Hodgkin/Reed Sternberg (HRS) cell by immunohistochemistry (IHC) using CD10, bcl6, MUM1/IRF4, and CD 138. Fifty-two of seventy-four (70.3%) cases were of late germinal center/early post-germinal center phenotype (CD10-/bcl6-/MUM1+/CD138-). Epstein-Barr virus (EBV) association using Epstein-Barr virus encoded RNA (EBER) RISH and EBV-LMP1 immunohistochemistry (IHC) revealed an EBV association of 93%. Tumor-associated macrophages (TAM) in the microenvironment were also assessed on the TMA by CD68 IHC, and most cases (59.7%) showed >25% TAMs, with no case showing ≤5%. These findings indicate that pediatric cHL in India is a tumor, predominantly, of late germinal center/early post-germinal center B cells, is almost invariably EBV associated, and with a high number of TAMs in the microenvironment. This latter finding suggests that criteria other than TAM scores need to be developed for risk stratification of pediatric EBV-associated HL especially in developing countries.
authors.affiliation: Department of Pathology, Kidwai Memorial Institute of Oncology , Bangalore , India.
authors.forename: Mohammed Abdul Lateef
authors.initials: MA
authors.lastname: Zameer
authors.forename: Chennagiri S
authors.initials: CS
authors.lastname: Premalata
authors.forename: Bandagadde
authors.initials: B
authors.lastname: Arunakumari
authors.forename: Lingappa
authors.initials: L
authors.lastname: Appaji
authors.forename: Clementina Rama
authors.initials: CR
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D005260:Female; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006689:Hodgkin Disease / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007194:India; D008264:Macrophages / Q000378:metabolism* / Q000473:pathology; D008297:Male; D016539:Reed-Sternberg Cells / Q000378:metabolism* / Q000473:pathology; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor
keywords: EBV; Hodgkin lymphoma; markers for germinal center B cells; markers for post-germinal center B cells; pediatric; tumor-associated macrophages