title: Immunoarchitectural patterns of progressive transformation of germinal centers with and without nodular lymphocyte-predominant Hodgkin lymphoma.
abstract: Progressive transformation of germinal centers (PTGC) has been frequently described in association with Hodgkin lymphoma, particularly nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). The aim of this study was to evaluate morphologic features of PTGC for better delineation of PTGC from early involvement by NLPHL. A total of 160 cases of PTGC were evaluated and included in the following 3 groups: 93 patients with PTGC who never developed a lymphoma, 23 patients with synchronous PTGC and NLPHL, and 44 patients with PTGC with antecedent or subsequent history of lymphoma. By histopathologic evaluation, 5 patterns of PTGC that reflected progressive dismantling of germinal centers were identified. There was no difference in the distribution of patterns 1 to 4 among the 3 groups of PTGC; however, in patients showing synchronous involvement of PTGC and NLPHL, pattern 5, which resembles a naïve B-cell follicle, was significantly more frequently observed (14/23) when compared with patients with PTGC who never developed a lymphoma (30/93; P = .0161). Furthermore, recognition of the spectrum of immunoarchitectural patterns of PTGC, including architectural and cytologic features, was helpful to better differentiate nodules involved by PTGC from NLPHL.
authors.affiliation: Dr Senckenberg Institute of Pathology, Goethe University, 60590 Frankfurt, Germany. Electronic address: s.hartmann@em.uni-frankfurt.de.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hartmann
authors.affiliation: Dr Senckenberg Institute of Pathology, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Ria
authors.initials: R
authors.lastname: Winkelmann
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Metcalf
authors.affiliation: Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors.forename: Jitsupa
authors.initials: J
authors.lastname: Treetipsatit
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Warnke
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.
authors.forename: Yasodha
authors.initials: Y
authors.lastname: Natkunam
authors.affiliation: Dr Senckenberg Institute of Pathology, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Martin-Leo
authors.initials: ML
authors.lastname: Hansmann
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000473:pathology*; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D018858:Germinal Center / Q000473:pathology*; D006689:Hodgkin Disease / Q000473:pathology*; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D008297:Male; D008875:Middle Aged
keywords: Classical Hodgkin lymphoma; Differential diagnosis; Immunoarchitectural patterns; Morphometric analysis; Nodular lymphocyte-predominant Hodgkin lymphoma; Progressive transformation of germinal centers