Hodgkin's and non-Hodgkin's lymphoma: spectrum of morphologic and immunophenotypic overlap

Ann Diagn Pathol. 1999 Oct;3(5):263-75. doi: 10.1016/s1092-9134(99)80021-5.

Abstract

Immunoperoxidase markers are useful and often essential in distinguishing among lymphocyte-predominant Hodgkin's lymphoma, T-cell-rich B-cell lymphoma, and lymphocyte-rich classic Hodgkin's lymphoma. However, it is becoming increasingly clear that these "entities" are closely related clonal B-lineage neoplasms that may intertransform and/or coexist. We hypothesized that, just as there are cases with morphologic overlap, there would also be immunophenotypic overlap that would be found when a series of such cases is studied in detail. Eight cases of lymphocyte predominant Hodgkin's lymphoma, eight cases of lymphocyte-rich classic Hodgkin's lymphoma, seven cases of T-cell-rich B-cell lymphoma, and four cases of large B-cell lymphoma with focal features of T-cell-rich B-cell lymphoma were examined by the immunoperoxidase technique for expression of CD3, CD15, CD30, CD20, CD57, epithelial membrane antigen, and Epstein-Barr virus latent membrane protein (EBV LMP). All eight of the lymphocyte-predominant Hodgkin's lymphoma cases had CD20+ lymphocytic and histiocytic cells and CD57+ rosettes; however, in two cases, occasional lymphocytic and histiocytic cells were also weakly positive for CD15, CD30, and EBV LMP. Among the eight lymphocyte-rich classic Hodgkin's lymphoma cases, CD15+ Reed-Sternberg (R-S) cells were found in seven; however, in three of these cases rare rosettes of CD57+ cells surrounded the R-S or lacunar cells. In one case of large B-cell lymphoma the malignant cells resembled R-S cells and were CD20+, EBV LMP+, CD30+, CD15-, and surrounded by rosettes of CD57+ T cells. The majority of the cases exhibited the "expected" immunophenotypic patterns; however, the exceptional cases that were found serve to confirm the interrelationship among these clonal B-lineage neoplasms.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Monoclonal / analysis
  • Antigens, Viral / analysis
  • B-Lymphocytes / pathology*
  • Biomarkers, Tumor / metabolism
  • Female
  • Hodgkin Disease / metabolism
  • Hodgkin Disease / pathology*
  • Hodgkin Disease / virology
  • Humans
  • Immunoenzyme Techniques
  • Immunophenotyping
  • Lymphoma, Non-Hodgkin / metabolism
  • Lymphoma, Non-Hodgkin / pathology*
  • Lymphoma, Non-Hodgkin / virology
  • Male
  • Middle Aged
  • T-Lymphocytes / pathology*
  • Viral Matrix Proteins / analysis

Substances

  • Antibodies, Monoclonal
  • Antigens, Viral
  • Biomarkers, Tumor
  • EBV-associated membrane antigen, Epstein-Barr virus
  • Viral Matrix Proteins