lewis-x-antigen and Hodgkin-Disease

Lymphomas account for less than 5% of thyroid malignant lesions. Vast majority of them are B-cell non-Hodgkin lymphomas (NHL), while Hodgkin lymphoma (HL) is extremely rare. Here we present two cases of HL, at baseline manifesting as a thyroid lesion. First patient, 29-year-old pregnant female, initially suspected for metastatic medullary thyroid cancer, was eventually diagnosed with mixed cellularity type of thyroid HL. Second patient, 22-year-old woman with suspicion of advanced thyroid cancer, was in the end diagnosed with an extra-lymphatic classical HL of the thyroid. In both cases, despite repeated fine-needle aspiration biopsy, cytological examination gave inconclusive or misleading results. On histopathological examination, thyroid tumor cells were positive for CD15 and CD30 antigen, which is typical for Reed-Sternberg cells. In the report authors also discuss difficulties in management as well as potential importance of novel methods such as FISH, PCR and other molecular techniques in diagnostics of thyroid lymphomas.. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2896947559559648.

Topics: Adult; Biomarkers, Tumor; Biopsy, Fine-Needle; Diagnosis, Differential; Female; Fucosyltransferases; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Molecular Diagnostic Techniques; Predictive Value of Tests; Pregnancy; Pregnancy Complications, Neoplastic; Reed-Sternberg Cells; Thyroid Nodule; Treatment Outcome; Young Adult

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), a distinct subtype of Hodgkin lymphoma, is a rare disease with a generally favorable prognosis. The hallmark of NLPHL is the presence of the lymphocytic and histiocytic cell, which, in contrast to the classic Reed-Sternberg cell, is CD20+, CD15-, and CD30-. NLPHL tends to have an indolent natural history, a long time to disease progression, a delayed time to relapse, and a high likelihood of presenting as early-stage disease. The evidence to guide the management of patients with NLPHL is limited by the rarity of this disease, but the available data support the use of involved-field radiation therapy alone for localized disease. Treatment-related late effects contribute significantly to the causes of death in patients treated for NLPHL.

Topics: Antigens, CD20; Disease Progression; Histiocytes; Hodgkin Disease; Humans; Lewis X Antigen; Lymphocytes; Neoplasm Staging; Prognosis; Radiotherapy Dosage; Rare Diseases

We report a case of an 81-year-old immunocompetent Mexican man who underwent an abdominal-perineal rectal resection for a mass clinically thought to be carcinoma. Histopathologic diagnosis revealed classical Hodgkin lymphoma, nodular sclerosis type, involving the rectum. The diagnosis was confirmed by immunohistochemical studies that showed that the neoplastic cells were positive for CD15 and CD30 and negative for CD45 (LCA). In situ hybridization for Epstein-Barr virus small-encoded RNA was also positive in the neoplastic cells. Hodgkin lymphoma arising in the rectum of immunocompetent patients is rare, with only 12 cases (including this one) reported in the literature. Of these, the diagnosis was confirmed by immunohistochemical studies in only two cases, and this is the first case assessed and shown to be positive for Epstein-Barr virus.

Topics: Aged; Aged, 80 and over; Biomarkers, Tumor; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Male; Rectal Neoplasms; RNA, Viral

The diagnosis of Hodgkin's disease is based on histopathologic examination and the demonstration of Reed-Sternberg cells. These cells express antigens (Ki-1/CD30 CD15) which are of diagnostic value. Two types of Hodgkin's disease are now identified: 1. the "classical Hodgkin's disease" which includes nodular sclerosis, mixed cellularity and some tumors rich in malignant cells formerly designated Hodgkin's disease with lymphocyte depletion; 2. the "lymphocyte predominance Hodgkin's disease" in particular the nodular form (paragranuloma). These lesions are now considered an indolent form of B-cell lymphoma with possible transformation into large B-cell lymphoma. Epstein-Barr virus is involved in the "Classical Hodgkin's disease" but not in the "Lymphocyte predominance Hodgkin's disease". However, the role of Epstein-Barr virus in the occurrence of the disease and the prognostic implications of its detection remain ro be elucidated.

Topics: Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, B-Cell; Reed-Sternberg Cells

The origin of the Reed-Sternberg cell, the neoplastic cell of Hodgkin's disease, has not been defined. We evaluated a case of Hodgkin's disease, mixed cellularity type, which presented in the retroperitoneum of a 45-year-old woman. Reed-Sternberg cells and Hodgkin's cells expressed the characteristic markers CD15 and CD30. In addition, they expressed the B-cell antigens CD19 and CD20, as well as CD45/leukocyte common antigen. Clonal rearrangement of the immunoglobulin heavy chain gene was detected by Southern blot analysis. These results suggest that some cases of Hodgkin's disease are derived from an activated cell of lymphoid origin. This case documents a close relationship between Hodgkin's disease and non-Hodgkin's lymphoma, and it demonstrates that even when newer ancillary techniques are employed these two entities can have overlapping features.

Topics: Antigens, CD; Antigens, CD19; Antigens, CD20; Antigens, Differentiation, B-Lymphocyte; B-Lymphocytes; Blotting, Southern; Female; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymph Nodes; Middle Aged; Reed-Sternberg Cells; Retroperitoneal Space

Three cases of Hodgkin's disease presenting primarily in the lung are described. All 3 patients presented with respiratory symptoms and chest X-rays revealed discrete masses within the lung parenchyma. CT examination of the mediastinum did not reveal regional or generalized lymphadenopathy at the time of diagnosis in 2 of the cases. A diagnosis of Hodgkin's disease was made on open lung biopsies and despite aggressive chemotherapy, 2 patients died within 2 yrs. The histological and immunocytochemical features of these cases were typical of that expected in Hodgkin's disease. However, the stated indolent course of primary pulmonary Hodgkin's disease is not invariable. Those patients with bilateral interstitial disease and systemic symptoms have a poor prognosis. Furthermore, it is difficult to exclude definitely lymph node involvement (although not enlarged) at the time of diagnosis. Since several cases described in the literature have concurrent and/or subsequent nodal involvement, the entity of primary pulmonary Hodgkin's disease without lymph node involvement is exceedingly rare.

Topics: Adult; Female; Hodgkin Disease; Humans; Lewis X Antigen; Lung Neoplasms; Male; Middle Aged; Reed-Sternberg Cells

The phenotypical identification of diagnostic cells is crucial for the diagnosis of Hodgkin's lymphoma (HL) on fine-needle aspiration cytology (FNAC). The aim of this study is to evaluate the immunocytochemical (ICC) expression of CD30, CD15, and PAX5 in Hodgkin's cells (HC) and Reed-Sternberg cells (RSC) on smears and cell-blocks (CB) of HL and to compare the performance of each antibody on smears and CB.. In 21 FNAC cases of histologically confirmed classical HL, ICC identification of HC and RSC was performed using CD15, CD30, and PAX5 on smears and CB, respectively.. CD30 was positive in 19/21 cases (90.5%; 11/11 smears and 8/10 CB), CD15 was positive in 14/21 cases (66.7%; 5/11 smears and 9/10 CB), and PAX5 was positive in 13/21 cases (61.9%; 9/11 smears and 4/10CB).. CD15, CD30, and PAX5 are useful to the FNAC identification of HC and RSC. CD30 is the most sensitive, followed by CD15 and PAX5, which are more effective on CB and smears, respectively.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy, Fine-Needle; Female; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; Neoplasm Proteins; PAX5 Transcription Factor; Retrospective Studies

Topics: Biopsy, Fine-Needle; Cell Transformation, Neoplastic; Diagnosis, Differential; Hodgkin Disease; Humans; Ki-1 Antigen; Leukemia, Lymphocytic, Chronic, B-Cell; Lewis X Antigen; Lymphadenopathy; Male; Middle Aged

the expression of CD30, CD15, CD50, and PAX5 are used to help in confirming diagnosis of HL and sALCL; however data on the proportion of these markers have not been available. The study was aimed to identify the proportion of CD30, CD15, CD50 and PAX5 expressions and characteristics of patients with HL and sALCL at Dharmais National Cancer Center Hospital between 2005 and 2015.. a retrospective observational study was conducted using data from medical records and histopathological results of HL and sALCL adult patients who sought treatment at the hospital between 2005 and 2015. Immunohistochemistry (IHC) examinations were performed and data on the proportion of positive CD30, CD15, CD50, and PAX5 expressions were analyzed descriptively.. a total of 45 patients were recruited in this study, with the majority (42 patients, 93.3%) were HL patients and only 6.7% were sALCL patients. The median age of HL patients was younger than sALCL patients; 35 (18-72 years old) versus 54 (49-61 years old). Moreover, the immunohistochemistry examination demonstrated that the positive CD15, CD30, CD50, and PAX5 expressions were found respectively in 37.5%, 88.9%, 31.2%, and 31.2% patients with HL; while in patients with sALCL, in spite of their small sample size, positive CD30, CD15, CD50 and PAX5 expressions were found in 100%; 66,7%; 50%; and 50%, respectively. Overall, CD15, CD50, and PAX5 positive expressions were found in 39.5%, 32.4%, and 32.4% patients who had HL and sALCL; while positive expression of CD30 was found in 89.5% of them.. present study shows that almost 90% patients have positive CD30 expression;  while the positive expressions of CD15, CD50, and PAX5 are found in less than 40% patients. It indicates that CD30 is an important diagnostic marker for HL and sALCL and it may improve treatment strategy.

Topics: Adolescent; Adult; Aged; Biomarkers, Tumor; Female; Hodgkin Disease; Humans; Immunohistochemistry; Indonesia; Intercellular Adhesion Molecule-3; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large-Cell, Anaplastic; Male; Middle Aged; PAX5 Transcription Factor; Retrospective Studies; Young Adult

Classical Hodgkin lymphoma (cHL) typically involves lymph node parenchyma, and a case with Hodgkin cells confined within nodal sinusoids is extremely rare. Herein we report a case of cHL with a sinusoidal growth pattern. This 15-year old patient presented with B symptoms and was found to have bilateral cervical lymphadenopathy and an anterior mediastinal mass. Biopsy of a cervical lymph node demonstrated cohesive clusters of Reed-Sternberg (RS)-like cells suggestive of sinusoidal growth with an extrasinusoidal mixed inflammatory cell infiltrate characteristic of the microenvironment seen in cHL. The RS cells/variants were positive for CD30 and CD15, and showed down-regulation of B-cell program and CD45, an immunophenotypic profile consistent with cHL. The sinusoidal growth pattern was also highlighted by EBV staining. To the best of our knowledge, this is the first case of EBV-positive cHL that displays a sinusoidal growth pattern. The patient was treated with children's high risk cHL chemotherapy protocol and responded well.

Topics: Adolescent; Biomarkers, Tumor; Herpesvirus 4, Human; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Male; Reed-Sternberg Cells

Topics: Biomarkers, Tumor; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Taiwan

: Acquired expression of CD30 is frequently noted in histological transformation of mycosis fungoides (MF), but simultaneous gain of CD15 accompanied with loss of pan-T-cell antigens are extremely rare. We report an unusual case of transformed MF with such an immunophenotypic alteration resembling classical Hodgkin lymphoma. The patient was an 81-year-old male with MF, who was initially treated with topical steroids and phototherapy. Despite the initial response, the patient developed a tumor-like skin lesion that was confirmed to be CD30-positive large T-cell lymphoma and was subsequently found to have a regional lymph node involvement by pleomorphic large cell lymphoma. Besides CD30, pleomorphic large cells were positive for CD15 but negative for all B cell- and T cell-specific antigens. Epstein-Barr virus was negative. Polymerase chain reaction-based assays demonstrated a clonal rearrangement of T-cell receptor gamma gene but detected no B-cell clone. The mechanism and clinical significance of this phenotypic conversion remains to be elucidated.

Topics: Aged, 80 and over; Biomarkers, Tumor; Cell Transformation, Neoplastic; Fucosyltransferases; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Primary Cutaneous Anaplastic Large Cell; Male; Mycosis Fungoides; Skin Diseases

Hodgkin's lymphoma (HL) is among the most frequent nodal lymphomas in the Western world and is classified into two disease entities: nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) and classical Hodgkin's lymphoma (cHL, 95% of all HL). HL lesions are characterised by a minority of clonal neoplastic cells, namely Hodgkin and Reed-Sternberg (HRS) cells and their variants in cHL and lymphocyte-predominant (LP) cells in NLPHL, both occurring within a microenvironment of, for example, reactive T and B cells, macrophages and granulocytes that are assumed to support the proliferation and maintenance of neoplastic cells through cytokines, chemokines and growth factors. Insulin-like growth factor I (IGF-I) is an important growth factor involved in proliferation, differentiation, apoptosis and cell survival of numerous (including immune) tissues and probably has a role in tumour pathogenesis and maintenance. Although HL is characterised by disturbed cell differentiation and apoptosis mechanisms, with the involvement of the IGF-I receptor (IGF-1R), the distinct location of IGF-I in HL has not yet been defined. We localise IGF-I by double-immunofluorescence in frequent neoplastic cells of all cHL and NLPHL cases investigated. Additionally, IGF-I immunoreactivity is detected in high endothelial venules and various immune cells within the surrounding tissue of cHL including neutrophils and macrophages. IGF-1R immunoreactivity of variable intensity is found in HRS cells and high endothelial venules within the microenvironment in cHL. We assume that autocrine and paracrine IGF-I plays an anti-apoptotic role in tumour pathogenesis and in shaping the tumour microenvironment.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Hodgkin Disease; Humans; Insulin-Like Growth Factor I; Lewis X Antigen; Lymphocytes; Male; Middle Aged; Sclerosis; Tumor Microenvironment; Young Adult

Hodgkin's lymphoma is believed to spread in an orderly fashion within the lymphatic compartment. In a minority of cases, after reaching the spleen, the neoplasm disseminates, reminiscent of metastasis. In the spleen, the Hodgkin-Reed-Sternberg tumor cells come across platelets in the blood vessels and mainly in the splenic red pulp. Based on this knowledge, we investigated the possibility of platelets inducing cell adhesion in Hodgkin's lymphoma cell lines. We showed that L428 and KMH-2 cells strongly adhere to thrombin-activated platelets. Cell adhesion to platelets is partially dependent on CD15 antigens (Lewis(X)), mainly sialyl-CD15, and P-selectin. KMH-2, as compared to L428 cells, showed increased binding due to its differential high expression of the sialyl-CD15. As a consequence of incubation with platelets, KMH-2 cells also produced increased amounts of tumor necrosis factors α (TNFα) followed by enhanced binding to human vascular endothelial cells (HUVEC). Incubation of both cell lines with activated platelets also induced activation of AP-1 transcription complex. Our findings are consistent with the concept that platelets play a critical role in the dissemination of HRS cells in HL, predominantly in the spleen, by increasing cell adhesion and thus promoting their proliferative and migratory properties beyond the lymphatic system.

Topics: Blood Platelets; Cell Adhesion; Cell Line, Tumor; Coculture Techniques; Fucosyltransferases; Glycosylation; Hodgkin Disease; Human Umbilical Vein Endothelial Cells; Humans; Lewis X Antigen; N-Acetylneuraminic Acid; P-Selectin; Platelet Activation; Protein Processing, Post-Translational; Thrombin; Tumor Necrosis Factor-alpha

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity. We performed a matched-pair analysis to evaluate the prognostic impact of several histopathological features in this distinct Hodgkin lymphoma subtype. Lymph node samples of NLPHL patients were tested for CD15, IgD, phosphorylated STAT6, ICOS and Epstein-Barr virus status of the malignant lymphocyte-predominant cells as well as epithelioid cell clusters and activated T cells in the microenvironment. None of these features was associated with a particular clinical outcome. However, patients presenting with epithelioid cell clusters showed a non-significant trend towards a lower relapse rate, justifying further evaluation of this marker.

Topics: Adolescent; Adult; Biomarkers, Tumor; Female; Fucosyltransferases; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunoglobulin D; Inducible T-Cell Co-Stimulator Protein; Lewis X Antigen; Lymphocyte Activation; Male; Matched-Pair Analysis; Middle Aged; Neoplasm Proteins; Neoplasm Staging; Prognosis; Recurrence; STAT6 Transcription Factor; T-Lymphocyte Subsets; Tumor Microenvironment; Young Adult

To profile the clinicopathologic features of a series of grey zone lymphoma (GZL) cases with hybrid features of diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma (CHL), with a purpose to gain an in-depth understanding of the borderline B-cell neoplasm.. The clinical, morphologic and immunophenotyical characteristics of 16 cases were retrospectively analyzed.. The patients were mostly male adults, with a male to female ratio of 1.7: 1.0 and a mean age of 40.2 years. Eight patients presented with peripheral nodal lesions and five cases with mediastinal involvement. Histologically and immunophenotypically, the 16 cases were classified into three sub-categories. In 4 cases, the morphologic features resembled CHL more closely, but the neoplastic cells showed uniform and intense positive staining of CD20 (pattern 1). Although the initial impression of the other 8 cases was that of DLBCL, the expression levels of CD20 and PAX5 were variable, and CD30 or CD15 was positive (pattern 2). A characteristic feature of pattern 3, observed in the remaining 4 cases, demonstrated a broad spectrum of morphology with hybrid features of both CHL and DLBCL. The neoplastic cells in pattern 3 were positive for CD20, CD30 and CD15. EBV-LMP1 was detected in 6 of the 11 tested cases. Clinically, most patients with GZL seemed insensitive to immuno-chemotherapy of the R-CHOP regimen.. The diagnostic criteria for GZL with features intermediate between DLBCL and CHL is proposed by the three histologic patterns commonly seen in these lesions. Cases presented with peripheral lesions might differ from those with mediastinal presentation pathologically. At current time, there is no effective treatment for these borderline B-cell lymphomas and the prognosis is poor.

Topics: Adolescent; Adult; Aged; Antibodies, Monoclonal, Murine-Derived; Antigens, CD20; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Diagnosis, Differential; Doxorubicin; Female; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; PAX5 Transcription Factor; Prednisone; Prognosis; Retrospective Studies; Rituximab; Vincristine; Viral Matrix Proteins; Young Adult

In order to identify immunohistochemical markers associated with primary refractory Hodgkin's lymphoma, 20 patients with primary refractory form at stage IIAB in complete remission underwent histological examination and immunohistochemical determination of Bcl-6, Bcl-2, c-kit (CD117), CD15, CD30, P-53, Ki-67. In the group with primary refractory Hodgkin's lymphoma at stage IIAB Bcl-6 expression was found in 2 patients (10%), Bcl-2 in 14 patients (70%), c-kit (CD117) in 16 patients (80%), CD15 in 9 patients (45%). The expression of CD30 and P-53 was observed in all patients in this group (100%). The expression of Ki-67 ranged from 20% to 100%, 80-100% in 16 patients (80%). As a result, multivariate analysis revealed no immunohistochemical markers of primary refractory Hodgkin's lymphoma. In univariate and multivariate analyzes in a group of primary refractory Hodgkin's lymphoma a high level P-53 expression (80-100%) was significantly associated with decreased overall survival. A 5-year overall survival in patients with Hodgkin's lymphoma with the expression level of P-53 < 80% was 78%, with the expression level of P-53 80-100%-22%. A 5-year overall survival of Hodgkin's lymphoma primary patients in complete remission significantly exceeded the rates of patients with primary refractory Hodgkin's lymphoma--100% vs. 52%.

Topics: Adult; Aged; Biomarkers, Tumor; DNA-Binding Proteins; Female; Fucosyltransferases; Gene Expression Regulation, Neoplastic; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Ki-67 Antigen; Lewis X Antigen; Male; Middle Aged; Predictive Value of Tests; Prognosis; Proto-Oncogene Proteins c-bcl-2; Proto-Oncogene Proteins c-bcl-6; Proto-Oncogene Proteins c-kit; Risk Assessment; Risk Factors; Tumor Suppressor Protein p53

Iatrogenic immunodeficiency-associated lymphoproliferative disorders are rare. A small subset of these lesions resembles classical Hodgkin lymphoma (CHL), but there are few data in the literature about these lesions. We describe 10 patients with autoimmune diseases treated with immunomodulator therapeutic agents who developed CHL. The autoimmune diseases included rheumatoid arthritis (n=5), systemic lupus erythematosus (n=2), dermatomyositis (n=1), autoimmune hepatitis (n=1), and Crohn disease (n=1), and the immunomodulatory therapies were methotrexate, azathioprine, tumor necrosis factor-α inhibitors, and thalidomide alone or in various combinations. The study group included 9 women and 1 man with a median age of 50 years (range, 25 to 77 y). The histologic features supported CHL in all cases with Reed-Sternberg (RS) and Hodgkin (H) cells in an inflammatory cell background, although the neoplasm could only be subclassified in 3 patients: 2 nodular sclerosis and 1 mixed cellularity. Immunohistochemical analysis supported the diagnosis of CHL. In all cases the RS-H cells were CD30. Nine of 10 cases were CD15, whereas CD20 was expressed variably in 4/10 cases. CD45/LCA was negative in 8 cases assessed. In situ hybridization for Epstein-Barr virus-encoded RNA was positive in the RS-H cells in 8/10 cases. The microenvironment of these lesions depicted a predominance of T-regulatory cells and M2 histiocytes. Clinical follow-up data were available for 7 patients, with a median posttreatment period of 27 months (range, 12 mo to 7 y). In all 7 patients immunomodulatory drug therapy was discontinued, and chemotherapy for CHL was administered; 2 patients also received local radiation. All 7 patients achieved complete remission and are alive. We conclude that iatrogenic immunodeficiency-associated CHL is highly associated with Epstein-Barr virus infection, and patients usually have a good outcome after discontinuation of immunomodulatory agents and chemotherapy for CHL.

Topics: Adult; Aged; Antigens, CD20; Autoimmune Diseases; Biomarkers, Tumor; Female; Fucosyltransferases; Herpesvirus 4, Human; Histiocytes; Hodgkin Disease; Humans; Iatrogenic Disease; Immunocompromised Host; Immunohistochemistry; Immunosuppressive Agents; In Situ Hybridization; Lewis X Antigen; Male; Middle Aged; Reed-Sternberg Cells; Remission Induction; RNA, Viral; T-Lymphocytes, Regulatory; Time Factors; Treatment Outcome; Tumor Microenvironment

High risk, unfavorable classical Hodgkin lymphoma (cHL) includes those patients with primary refractory or early relapse, and progressive disease. To improve the availability of biomarkers for this group of patients, we investigated both tumor biopsies and peripheral blood leukocytes (PBL) of untreated (chemo-naïve, CN) Nodular Sclerosis Classic Hodgkin Lymphoma (NS-cHL) patients for consistent biomarkers that can predict the outcome prior to frontline treatment.. Bioinformatics data mining was used to generate 151 candidate biomarkers, which were screened against a library of 10 HL cell lines. Expression of FGF2 and SDC1 by CD30+ cells from HL patient samples representing good and poor outcomes were analyzed by qRT-PCR, immunohistochemical (IHC), and immunofluorescence analyses.. To identify predictive HL-specific biomarkers, potential marker genes selected using bioinformatics approaches were screened against HL cell lines and HL patient samples. Fibroblast Growth Factor-2 (FGF2) and Syndecan-1 (SDC1) were overexpressed in all HL cell lines, and the overexpression was HL-specific when compared to 116 non-Hodgkin lymphoma tissues. In the analysis of stratified NS-cHL patient samples, expression of FGF2 and SDC1 were 245 fold and 91 fold higher, respectively, in the poor outcome (PO) group than in the good outcome (GO) group. The PO group exhibited higher expression of the HL marker CD30, the macrophage marker CD68, and metastatic markers TGFβ1 and MMP9 compared to the GO group. This expression signature was confirmed by qualitative immunohistochemical and immunofluorescent data. A Kaplan-Meier analysis indicated that samples in which the CD30+ cells carried an FGF2+/SDC1+ immunophenotype showed shortened survival. Analysis of chemo-naive HL blood samples suggested that in the PO group a subset of CD30+ HL cells had entered the circulation. These cells significantly overexpressed FGF2 and SDC1 compared to the GO group. The PO group showed significant down-regulation of markers for monocytes, T-cells, and B-cells. These expression signatures were eliminated in heavily pretreated patients.. The results suggest that small subsets of circulating CD30+/CD15+ cells expressing FGF2 and SDC1 represent biomarkers that identify NS-cHL patients who will experience a poor outcome (primary refractory and early relapsing).

Topics: Adult; Aged; Biomarkers, Tumor; Computational Biology; Female; Fibroblast Growth Factor 2; Fucosyltransferases; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplastic Cells, Circulating; Retrospective Studies; Syndecan-1; Treatment Outcome; Young Adult

Topics: Adolescent; Antigens, CD20; CD3 Complex; Child, Preschool; Diagnosis, Differential; Female; Hodgkin Disease; Humans; Hyperplasia; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphatic Diseases; Male; Reed-Sternberg Cells; Retrospective Studies

An association between classical Hodgkin lymphoma (cHL) and mycosis fungoides (MF) or lymphomatoid papulosis has been reported in the literature. However, there can be considerable morphologic and immunophenotypic overlap between cHL and nodal involvement by CD30-positive T-cell lymphoproliferative disorders (CD30-T-LPD). To examine this potential association, biopsies from patients with a history of MF or primary cutaneous CD30-T-LPD and lymph node biopsies reported as either CD30-positive T-cell lymphoma (TCL) with Hodgkin-like cells or cHL were retrieved from the authors' institution. Of 11 cases identified, 10 were considered CD30-positive TCL with Hodgkin-like cells, whereas 1 was confirmed as cHL upon review. Five cases originally diagnosed as cHL were revised as CD30-positive TCL. Cases of CD30-positive TCL with Hodgkin-like cells showed a male predominance (M:F, 4:1) with a median age of 53 years (range, 44 to 72 y). Nearly all patients (9/10) initially presented with skin lesions. In 7/10 patients the draining lymph node was involved, whereas in 3 cases this could not be confirmed. Tumor cells morphologically resembled Hodgkin/Reed-Sternberg cells; they were uniformly strongly positive for CD30, and CD15 was expressed in 9/10 (90%) cases. A T-cell derivation was confirmed by T-cell antigen expression (7/10) and clonal rearrangement of T-cell receptor genes (9/10). In 3 cases a common T-cell clone was identified in skin and lymph node. B-cell markers (CD20/PAX5) were consistently negative. In 1 case the diagnosis of cHL followed by lymphomatoid papulosis was confirmed, with Hodgkin/Reed-Sternberg cells expressing PAX5, CD30, and CD15. In situ hybridization studies for Epstein Barr virus were negative. We show that cHL is less often associated with MF and primary cutaneous CD30-T-LPD than previously thought and that the coexpression of CD30 and CD15 in these TCLs may lead to a mistaken diagnosis of cHL.

Topics: Adult; Aged; Diagnosis, Differential; Female; Genetic Markers; Herpesvirus 4, Human; Hodgkin Disease; Humans; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Lymphatic Metastasis; Lymphoma, Primary Cutaneous Anaplastic Large Cell; Male; Middle Aged; Mycosis Fungoides; Skin Neoplasms

Epstein-Barr virus (EBV) can be associated with both classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma of the B-cell type, particularly in immunodeficient patients or elderly individuals. While polymorphic variants of EBV-positive large B-cell lymphoma (EBV+ DLBCL) frequently resemble cHL in morphology, and thereby may cause diagnostic difficulty, a true gray zone lymphoma with overlapping morphological and immunophenotypical features of EBV+ DLBCL and EBV+ cHL has not been reported in the literature. We describe a unique case of an EBV+ malignant lymphoma of B-cell origin with hybrid features of EBV+ DLBCL and EBV+ cHL in a 67-year-old female without an identifiable etiology for immunodeficiency. The biopsy of an enlarged lymph node showed a polymorphic infiltrate containing Reed-Sternberg-like pleomorphic large cells, which were positive for CD30 and CD15. Although CD20 was negative and PAX5 and CD45 were down-regulated, the pleomorphic large cells expressed multiple other B-cell antigens which are characteristically absent in cHL. EBV-encoded RNA hybridization (EBER) studies demonstrated nuclear reactivity in the large cells as well as in the smaller bystander cells. A clonal rearrangement of the immunoglobulin heavy chain gene was also detected by PCR. Although the results of the EBV and genotypic studies suggest this case may be an example of EBV+ DLBCL of the elderly instead of EBV+ cHL, the immunophenotype is strikingly ambiguous. Thus, this case may represent an interface between EBV+ DLBCL and EBV+ cHL.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Epstein-Barr Virus Infections; Etoposide; Female; Gene Rearrangement, B-Lymphocyte, Heavy Chain; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Prednisone; Procarbazine; Reed-Sternberg Cells; Remission Induction; Vincristine

Topics: Adult; Diagnosis, Differential; Female; Granulomatous Disease, Chronic; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Large-Cell, Anaplastic; Young Adult

To study clinical and histopathological features, and diagnosis of mediastinal tumours of haematopoietic and lymphoid tissues (MTHL).. Forty cases of MTHL were analyzed for clinicopathology by microscopy and immunohistochemical staining and in situ hybridization, according to the updated 2008 WHO classification of tumours of haematopoietic and lymphoid tissues.. In 40 cases of MTHL, there were 20 males and 20 females. The ratio of male/female was 1:1. The mean age was 31.8 years and median age was 29 years (range, 12 - 70 years).Superior vena cava syndrome was observed in 28 cases. The specimens of 4 cases were obtained by lumpectomy, whereas 36 cases by biopsy (25 cases by thoracoscopy, 1 by core needle aspiration). Twenty cases lay in anterior mediastinum, and 2 in posterior, 1 in superior, 8 in anterior and superior, 2 in posterior and superior, 2 in anterior and middle, 1 in middle and anterior mediastinum.Frozen section were performed in 28 cases, and 17 cases were diagnosed as tumours of haematopoietic and lymphoid tissues (consistency ratio was 60.7%). Twelve cases were classical Hodgkin lymphomas (cHL) (8 were nodular sclerosis subtype, and 3 were mixed cellarity, 1 was lymphocyte-rich subtype), and 10 were primary mediastinal (thymic) large B cell lymphoma (PMBCL), 10 were precursor lymphocyte neoplasm [8 were T lymphoblastic leukemia/lymphomas (T-LBL), 2 were B-LBL], 1 was MALT lymphoma, 1 was composite lymphoma (PMBCL and cHL), 2 were myeloid sarcomas, 4 were gray zone lymphomas (GZL) (3 had morphology reminiscent of cHL, and 1 of DLBCL, all cases were positive for CD20, PAX5, CD30 and CD15).EBER were detected in 11 cases by in situ hybridization, 2 of which were positive (18.2%), and the 2 positive cases were cHL.. MTHLs occur predominantly in adolescents and young adults, mainly present as superior vena cava syndrome and anterior mediasinal masses. cHL, PMBCL, T-LBL were the most common MTHLs.GZLs mainly occur in young adults, those whose morphology reminiscent of cHL, immunohistochemistry reminiscent of PMBCL, and vice versa. Thoracoscopy, frozen section and a suitable panel of antibodies were practical approaches to MTHL.

Topics: Adolescent; Adult; Aged; Antigens, CD20; Child; Female; Follow-Up Studies; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Lymphoma, B-Cell; Lymphoma, B-Cell, Marginal Zone; Male; Mediastinal Neoplasms; Middle Aged; PAX5 Transcription Factor; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma; Retrospective Studies; Superior Vena Cava Syndrome; Survival Rate; Young Adult

The Lewisx trisaccharide, also referred to as the CD15 antigen, is a diagnostic marker used to distinguish Hodgkin's lymphoma from other lymphocytic cancers. However, the role of such fucosylated structures remains poorly understood, in part because carriers of Lewisx structures on Hodgkin's Reed-Sternberg cells have not been identified.. GalMBP, an engineered carbohydrate-recognition protein that binds selectively to oligosaccharides with paired terminal galactose and fucose residues, has been used in conjunction with proteomic and glycomic analysis to identify glycoprotein carriers of Lewisx and related glycan structures in multiple Hodgkin's Reed-Sternberg cell lines.. Multiple glycoproteins that bind to GalMBP and carry CD15/Lewisx have been identified in a panel of six Reed-Sternberg cell lines. The most commonly identified Lewisx-bearing glycoproteins are CD98hc, which was found in all six cell lines tested, and intercellular adhesion molecule-1 and DEC-205, which were detected in five and four of the lines, respectively. Thus, several of the most prominent cell adhesion molecules on the lymphomas carry this characteristic glycan epitope. In addition, the Hodgkin's Reed-Sternberg cell lines can be grouped into subsets based on the presence or absence of less common Lewisx-bearing glycoproteins.. CD98 and intercellular adhesion molecule-1 are major carriers of CD15/Lewisx on Reed-Sternberg cells. Binding of DC-SIGN and other glycan-specific receptors to the Lewisx epitopes on CD98 and intercellular adhesion molecule-1 may facilitate interaction of the lymphoma cells with lymphocytes and myeloid cells in lymph nodes.

Topics: Carrier Proteins; Cell Line, Tumor; Epitopes; Glycoproteins; Hodgkin Disease; Humans; Lewis X Antigen; Protein Binding; Proteomics; Reed-Sternberg Cells

Topics: Adult; Aged; Female; Fucosyltransferases; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Lymphocytes; Male; Middle Aged

Topics: Adult; Female; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Sputum

Intracranial and intraspinal involvement is a rare complication of Hodgkin's lymphoma. Intracranial involvement is observed in 0.2 to 0.5 percent of patients with Hodgkin's lymphoma. No specific risk factors associated with intracranial involvement have been found. We report intracranial involvement of Hodgkin's lymphoma in a patient who had previously undergone thyroidectomy due to thyroid papillary carcinoma.

Topics: Adult; Brain Neoplasms; Carcinoma, Papillary; Central Nervous System Neoplasms; Female; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Magnetic Resonance Imaging; Neoplasm Metastasis; Risk Factors; Thyroidectomy; Tomography, X-Ray Computed

Topics: Aged; B-Lymphocytes; Diagnosis, Differential; Female; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse

Topics: Cerebellum; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Magnetic Resonance Imaging; Male; Recurrence; Reed-Sternberg Cells; Young Adult

Lymphocyte depleted classical Hodgkin lymphoma (LDHL) is a vanishing category of classical Hodgkin lymphoma (CHL); many cases previously placed in this category are now recognised as diffuse large B-cell lymphoma (DLBCL), anaplastic large-cell lymphoma (ALCL), or nodular sclerosis CHL with lymphocyte depletion. In addition, the recent recognition of high grade B-cell lymphomas intermediate between DLBCL and CHL (grey-zone lymphomas) raises the question of whether LDHL exists at all as a category of CHL. We studied eight cases that fulfilled diagnostic criteria of LDHL according to the 2008 WHO Classification. The cases involved lymph nodes (7 cases) and pleura (1 case) from four males and four females (age 30-71 years; median 62 years). All tumors contained numerous Hodgkin-Reed-Sternberg (HRS) cells, fibroblasts and histiocytes and scattered lymphocytes. In three cases the tumors had a more diffuse fibrotic appearance, while in five cases they appeared reticular and anaplastic. Neoplastic cells in all cases expressed CD30, CD15, fascin, weak PAX5 and MUM-1 and lacked CD45, Alk-1, EMA, CD3, CD68, Mart-1 and cytokeratin. Oct.2 and/or Bob-1 were expressed in all cases. Two cases variably expressed CD20 but were CD79a negative. Four cases were positive for EBV. All the four cases with adequate DNA had clonally rearranged IGH genes. The combined morphologic, immunophenotypic and molecular genetic features of this group of cases distinguish LDHL from other disease entities, including grey-zone lymphomas.

Topics: Adult; Aged; Carrier Proteins; Female; Gene Rearrangement; Hodgkin Disease; Humans; Immunoglobulin Heavy Chains; Immunohistochemistry; Interferon Regulatory Factors; Ki-1 Antigen; Lewis X Antigen; Lymphocytes; Male; Microfilament Proteins; Middle Aged; PAX5 Transcription Factor; Polymerase Chain Reaction; Reed-Sternberg Cells

The burden of lymphomas on the health care system in Nigeria is enormous. Correct diagnosis and identification of aetiological factor are important steps in reducing this burden.. Eight cases diagnosed as HL within a period of six years at the Obafemi Awolowo University teaching Hospital, Ile-Ife, Nigeria by haematoxylin and eosin (Hand E) only were immunophenotyped using the indirect immunoperoxidase method. Epstein-Barr virus latent membrane protein-1 (LMP-1), CD15 and CD30 immunohistochemistry was also performed. The clinical characteristics of each patient were documented.. To document the frequency of involvement of Epstein-Barr virus in cases of HL seen in a university hospital in Nigeria.. Out of the eight cases diagnosed by H&E as HL immunophenotyping showed only five were HL. The rest were non-Hodgkin's lymphoma (2 diffuse large B-cell and 1 null cell ALCL). All were cases of classical HL with 60% being of the mixed cellularity (MC) subtype. There were 2 males and 3 females with ages ranging from 7 years to 40 years. All presented with cervical lymphadenopathy and three had splenomegaly in addition. 60% of the tumour was EBV positive, all of the MC subtype. Three patients had chemotherapy. Eventually all were lost to follow-up. There was no case of the nodular lymphocyte predominance variant.. Mixed cellularity is the most common subtype and is the only subtype associated with EBV positivity in this study. Epstein-Barr virus probably plays an important role in the aetiology of HL in Nigerians.

Topics: Adolescent; Adult; Biomarkers, Tumor; Child; Epstein-Barr Virus Infections; Female; Hodgkin Disease; Hospitals, Teaching; Humans; Immunohistochemistry; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Male; Nigeria; Viral Matrix Proteins; Young Adult

We report the clinical and immunohistological features of two cases of chronic lymphocytic leukaemia (CLL) with Hodgkin's transformation. These cases occurred in a 70-year-old man with a three-year history of CLL and in a 76-year-old man with a few months history of CLL. Microscopic examination showed the presence of large tumor cells with the morphological and immunophenotypic features of classical Hodgkin and Reed-Sternberg (R-S) cells, in a background of otherwise typical B-CLL. The transformation of CLL into large B cell lymphoma (Richter's syndrome) is a well-documented phenomenon. Only rarely does CLL transform into Hodgkin's lymphoma, but this diagnosis is often easy and offers few differential diagnoses. The major points of interest lie in the pathogenetic relationship between CLL and Hodgkin's disease, and in the potential clinical implications of this peculiar condition. Literature on the subject indicates that identical IgH gene rearrangements in micromanipulated R-S and CLL cells have been identified in 7/12 cases. In these patients, the R-S and CLL cells belong to the same clonal population, suggesting a progression from the underlying CLL cells. This group appears to have a poor prognosis, identical to classical Richter's syndrome. In other cases, the R-S cells were often Epstein-Barr virus (EBV) positive and did not share the clonal rearrangements identified in CLL cells, suggesting that Hodgkin's disease in these patients could represent a second malignancy, EBV-related and favored by immunosuppression, associated with a better prognosis.

Topics: Acute Disease; Aged; Antibodies; Antigens, CD; CD79 Antigens; Genetic Variation; Hodgkin Disease; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Lewis X Antigen; Male; Neoplasm Staging; Reed-Sternberg Cells

Changes in the definition of lymphocyte-depleted classic Hodgkin lymphoma (LDcHL) have recently led to reclassification of many cases as other pleomorphic lymphomas. We have set out to identify LD cases in our cohort of cHL patients and determine their clinical and biological characteristics properties. We defined the morphologic picture of LDcHL according to selected criteria and determined how its features differ from those of other subtypes of cHL. Twelve of 201 cHL patients (5.9%) were diagnosed as showing LDcHL histology, a higher percentage of LDcHL than in most recent series. The LD cases were most often positive for Epstein-Barr virus and for sialyl-CD15. Defining the cases as either reticular (eight) or as diffuse fibrosis (three) variants was critical to the diagnostic approach. We conclude that LDcHL may be a neglected entity.

Topics: Female; Fibrosis; Herpesvirus 4, Human; Hodgkin Disease; Humans; Lewis X Antigen; Lymphocytes; Male; Retrospective Studies; Spleen

Hodgkin and Reed-Sternberg (HRS) cells of classical Hodgkin's Lymphoma (CHL) express B-cell marker CD20 with a reported frequency of 5%-58%. The prognostic significance of CD20 expression in HRS cells of CHL is still controversial. This study was to investigate the prognostic significance of CD20 expression in naive CHL patients.. The expression of CD20, CD15 and CD30 in 70 specimens of CHL were detected by immunohistochemistry; tumor morphology was observed with HE staining. A sample with CD20 expression on more than 10% of HRS cells was considered CD20-positive. The failure-free survival (FFS) and overall survival (OS) rates were compared by log-rank test. Cox proportional hazard model was used in multivariate analysis.. Of the 70 cases of CHL, 21 (30.0%) were CD20-positive, 26 (37.1%) were CD15-positive, and all were CD30-positive. The positive rate of CD20 was significantly higher in the patients aged > or =45 years than in those aged <45 years (53.3% vs. 23.6%, P=0.026). The patients were followed up for a median of 58.3 months. The 5-year FFS rates were 76.2% in CD20-positive patients and 77.6% in CD20-negative patients (P=0.484). The 5-year OS rates were 80.4% in CD20-positive patients and 92.5% in CD20-negative patients (P=0.006). Cox multivariate analysis showed that age and stage were independent prognostic factors for FFS and OS.. The positive rate of CD20 is relatively low in HRS cells of CHL. It is higher in the patients aged > or =45 years than in those aged <45 years. However, according to our results, the expression of CD20 is not an independent prognostic factor for FFS and OS of naive CHL patients.

Topics: Adolescent; Adult; Age Factors; Aged; Antigens, CD20; Child; Child, Preschool; Female; Follow-Up Studies; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; Proportional Hazards Models; Reed-Sternberg Cells; Survival Rate; Young Adult

This study was conducted to assess the clinical and prognostic significance of lack of CD15 expression, proliferative index (PI), and expression of tumor suppressor protein p53 in pediatric classical Hodgkin lymphoma (CHL).. Pre-treatment lymph node (LN) biopsies were studied by immunohistochemistry for immunophenotyping of the lymphoma and with Ki-67 (PI) and p53 antibodies. Expression of CD15 antigen on the Hodgkin and Reed-Sternberg (H-RS) cells, proliferation, and apoptosis parameters were correlated with clinical stage, response to chemotherapy alone, overall (OS) and failure-free survival (FFS).. One hundred and twenty-one children with CHL were studied. Expression of Ki-67 and p53 in H-RS cells was seen in 100% and 89.9% of the cases, respectively. Loss of CD15 expression, seen in 12 (9.9%) cases, was significantly associated with p53 negativity and was an independent prognostic factor for poor OS and poor FFS. PI

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cell Growth Processes; Child; Child, Preschool; Cyclophosphamide; Dacarbazine; Disease-Free Survival; Doxorubicin; Female; Hodgkin Disease; Humans; Immunophenotyping; Kaplan-Meier Estimate; Ki-67 Antigen; Lewis X Antigen; Male; Neoplasm Staging; Prednisone; Procarbazine; Retrospective Studies; Tumor Suppressor Protein p53; Vinblastine; Vincristine

Topics: Antineoplastic Combined Chemotherapy Protocols; Cell Growth Processes; Child; Child, Preschool; Disease-Free Survival; Hodgkin Disease; Humans; Lewis X Antigen

CD15 is a useful immunohistochemical marker to identify Reed-Sternberg cells in classical Hodgkin's lymphoma (HL) and to distinguish it from HD-like neoplasms, but data from the literature concerning its expression in HL are quite variable. Using immunohistochemistry we compared the reactivity of three different anti-CD15 clones (MMA, C3D1 and BY87) and found that anti-CD15 MMA clone is a superior reagent in identifying atypical cells, detecting more numerous cells in 28.2%, and being the only positive marker in 12.8% of cases. We conclude that it is advisable to include this reagent in diagnostic immunohistochemical panels.

Topics: Animals; Antibodies, Monoclonal; Antigen-Antibody Reactions; Antigens, Neoplasm; Diagnosis, Differential; Hodgkin Disease; Humans; Immunoglobulin M; Lewis X Antigen; Lymphoma, Non-Hodgkin; Lymphoma, T-Cell, Peripheral; Mice; Reed-Sternberg Cells; Sensitivity and Specificity

Topics: Adult; Biopsy; Castleman Disease; Female; Hodgkin Disease; Humans; Immunoglobulin kappa-Chains; Immunoglobulin lambda-Chains; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Plasma Cells; Reed-Sternberg Cells

Topics: Aged; Chromosomes, Human, Pair 11; Chromosomes, Human, Pair 14; Cyclin D1; Fatal Outcome; Female; Hodgkin Disease; Humans; In Situ Hybridization, Fluorescence; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Mantle-Cell; Reed-Sternberg Cells; Translocation, Genetic

Interfollicular Hodgkin's Disease is characterised by reactive follicular hyperplasia with involvement of the interfollicular area of lymph node by Hodgkin's lymphoma. It represents a peculiar pattern of focal involvement of lymph node and does not constitute a classical subtype. Its importance rests in the fact that it can be misinterpreted as one of the many causes of reactive hyperplasia of lymph node and not as Hodgkin's disease. Eleven cases of interfollicular Hodgkin's disease were diagnosed in a period of five years. Majority of the patients were less than twenty years and all had localised lymphadenopathy. Lymph node biopsy showed follicular hyperplasia with expanded interfollicular area. Careful search of the interfollicular area showed infiltration by inflammatory cells and scattered Reed-Sternberg and Hodgkin's cells. Immunohistochemistry with CD 15 and CD 30 highlighted the atypical cells. This report emphasises on the problems in diagnosis of interfollicular Hodgkin's disease.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Hodgkin Disease; Humans; Hyperplasia; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Male; Middle Aged; Reed-Sternberg Cells

Classical Hodgkin's lymphoma (cHL) rarely coexists as composite lymphoma with B-cell non-Hodgkin's lymphoma (B-NHL). We characterized 12 cases of composite marginal zone B-cell lymphoma (MZBL) and cHL by immunohistochemistry and molecular biology.. Eight patients had gastric MZBL of mucosa-associated lymphoid tissue (MALT)-type, in five cases with a diffuse large B-cell lymphoma component. Concurrent cHL was observed either in the stomach wall, regional, or distant lymph nodes. One patient each had composite pulmonary/thyroid MZBL of MALT-type and cHL. In two cases, nodal composite MZBL and cHL was observed. cHL displayed features of mixed cellularity type in 10 cases, while in two cases only scattered Hodgkin- and Reed-Sternberg (H/RS) cells were noted. H/RS cells expressed CD30, multiple myeloma oncogene 1 protein (MUM1P), p53 (100%), CD15 (58%), CD20 (58%) and Epstein-Barr virus-associated LMP1 (50%). No t(11;18)(q21;q21) was detected in composite MZBL of MALT-type and cHL.. MZBL and cHL may occur as composite lymphoma, possibly reflecting clonal lymphoma progression. Derivation from extranodal MZBL of MALT-type should be excluded in cases in which a diagnosis of primary extranodal cHL is considered.

Topics: Aged; Aged, 80 and over; Antigens, CD; Antigens, CD20; B-Lymphocytes; Bronchi; CD79 Antigens; Chromosomes, Human, Pair 11; Chromosomes, Human, Pair 18; Female; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphoma, B-Cell; Lymphoma, B-Cell, Marginal Zone; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Proto-Oncogene Proteins c-bcl-2; Receptors, Antigen, B-Cell; Stomach; Thyroid Gland; Translocation, Genetic; Tumor Suppressor Protein p53

Our objective was to evaluate the usefulness of cytomorphologic assessment in the accuracy of diagnosis of Hodgkin's disease (HD), using imprint cytological preparations over a 18-yr period. Imprint materials from 34 HD cases were reviewed using cytomorphological and immunocytochemical studies. Twenty-six cases (76.5%) were diagnosed to be HD and 6 cases (17.6%) were suspected to be HD, but 2 cases (5.9%) were cytologically diagnosed as reactive lesions, because of an insufficient number of Reed-Sternberg (RS) cells. The 6 suspected cases were definitively diagnosed as HD, using immunocytochemistry. Immunophenotyping of RS cells in 32 cases (excluding the two cases of reactive lesions) showed CD30+ in 31 (96.9%) cases, CD15+ in 22 (68.8%) cases and CD20+ in 12 (37.5%) cases. RS cells were immunophenotypically classified into five groups: A, (CD 30+, 15+, 20-) 15 (46.9%); B, (CD30+, 15-, 20-) 5 (15.6%); C, (CD 30+, 15+, 20+) 6 (18.8%); D, (CD30+, 15-, 20+) 5 (15.6%); and E, (CD30-, 15+, 20+) 1 (3.1%). Cytomorphologic differences in RS cells were identified between group D and other groups (CD15+ and/ or CD20-). The former had a low polymorphic shape (like popcorn), and the latter had a more classical polymorphic shape. Epstein-Barr virus (EBV)-latent membrane protein-1(LMP-1) was identified in 16 (50%) cases. LMP-1 expression was found not only in classic RS cells, but also in smaller variants. These variants did not match the morphologic criteria of RS cells, but expressed the common phenotype (CD30+, CD15+/-) of RS cells, suggesting the same cellular origin as RS cells. This study demonstrated that imprint cytology from lymph node biopsies can be a useful tool for the diagnosis and the evaluation of the cellular biology of HD.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, CD20; Child; Cytodiagnosis; Female; Hodgkin Disease; Humans; Immunohistochemistry; Japan; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; Reed-Sternberg Cells; Reproducibility of Results; Sensitivity and Specificity; Viral Matrix Proteins

A chest wall abscess is a very rare presentation of extranodal Hodgkin's lymphoma (HL); only one case has been reported to date. Here, we describe a case of a 38-yr-old man with HL whose initial presentation was a chest wall abscess. The diagnosis of HL was suggested by cytological examination of the purulent discharge and was confirmed subsequently by excisional biopsy of cervical lymph node.

Topics: Abscess; Adult; Antibiotics, Antineoplastic; Chest Pain; Diagnosis, Differential; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Lymph Nodes; Male; Sclerosis; Thoracic Diseases

Topics: Adult; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antigens, CD; Antigens, CD20; Antineoplastic Agents; CD79 Antigens; Cell Differentiation; Chromosome Deletion; Chromosomes, Human, Pair 6; Epstein-Barr Virus Infections; fas Receptor; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Kidney Transplantation; Leukocyte Common Antigens; Lewis X Antigen; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Lymphoproliferative Disorders; Male; Postoperative Complications; Receptors, Antigen, B-Cell; Rituximab; Treatment Outcome

Topics: Adult; Diagnosis, Differential; Female; Histiocytoma, Malignant Fibrous; Histiocytosis, Langerhans-Cell; Histiocytosis, Sinus; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Lung; Lung Neoplasms; Lymph Nodes

In spite of recent great advances in our understanding of both Hodgkin lymphoma (HL) and anaplastic large cell lymphoma (ALCL), occasionally there are CD30-positive large cell hematopoietic neoplasms, in which the morphologic and phenotypic features overlap to such an extent that they cannot easily be classified. We report a histologically unusual case of HL that mimicked ALCL, but had phenotypical characteristics of HL. The neoplastic cells resembling Reed-Sternberg cells or Hodgkin cells were mainly situated within sinusoidal spaces, which are characteristically seen in ALCL. However, they showed unequivocal expression of both CD30 and CD15, and no aberrant antigen expression to suggest ALCL (BSAP+, EMA-, LCA-, CD43-, CD2-, CD3-, CD4-, CD45RO-, ALK-, granzymeB-), with negative TCR gene rearrangement and no expression of EBV. HL with intrasinusoidal pattern has rarely been described, but we suggest that, although cases of HL with such a striking sinusoidal pattern are rare, nevertheless do exist. Since the identification of sinusoidal infiltration by CD30-positive neoplastic cells may lead to a mistaken view of ALCL, wide panel of antibodies should be used to confirm the diagnosis.

Topics: Diagnosis, Differential; Female; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphoma, Large-Cell, Anaplastic; Middle Aged; Neoplasm Invasiveness; Phenotype; Reed-Sternberg Cells

Topics: Diagnosis, Differential; Hodgkin Disease; Humans; Lewis X Antigen; Lymphoproliferative Disorders; Reed-Sternberg Cells

Histopathological examination remains crucial for diagnosis and classification of Hodgkin's disease (HD) but poses problems when characteristic features of HD are not present and hence the value of immunohistochemistry. Experience with immunohistochemistry in developing countries is limited due to cost.. To describe the immunophenotypic and histologic types of Hodgkin's disease in Kampala, Uganda. A cross-sectional study.. Makerere University Medical School, Department of Pathology.. Two hundred formalin fixed, paraffin- embedded biopsies, which had been previously diagnosed as Hodgkin's disease in the Makerere University, Department of Pathology from 1980--2000, were re-assessed with haematoxylin and eosin. The sections were then subjected to immunohistochemistry using monoclonal antibodies: leucocyte common antigen (CD45), antibodies to Reed-Sternberg cells (CD15, CD30) and to B cells (CD20).. Of the 200 biopsies, 171 (71.3%) were diagnosed as Hodgkin's disease using immunohistochemistry. The mean age of the 171 cases was 26.1(SD 16.2) years; mode 20.0; median 22.5 years. The 15-24 year age group was most affected (47.2%). There were more males (65.9%) than females and most were Baganda who are the main tribe in the central region of Uganda. Mixed cellularity (35.7 %) and lymphocyte depleted (24.6 %) HD were the commonest histological types. Classic HD (CD30, CD 15, CD20, CD45) was the most commonest (77.8%) immunophenotype.. Classic Hodgkin's disease (CD30, CD 15, CD20 and CD45) is the most commonest immunophenotype in Kampala, Uganda, and mixed cellularity and Iymphocyte depleted are the main histologic subtypes.

Topics: Adolescent; Adult; Age Distribution; Aged; Antigens, CD20; Biopsy; Child; Child, Preschool; Coloring Agents; Cross-Sectional Studies; Developing Countries; Eosine Yellowish-(YS); Female; Hematoxylin; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Male; Middle Aged; Sex Distribution; Socioeconomic Factors; Uganda

To investigate the apoptosis-related genes and protein expression patterns in relation to classical Hodgkin lymphomas (CHL) and the origin of H/RS cell.. Sixty-two cases of CHL were retrieved from Shanxi Tumor Hospital files. An ABC method was used to detect the expression of bcl-2, CD3, CD20, CD30, CD15 and CD10, a double immunohistochemical method to study the H/RS cells P53 expression, a double immunohistochemical ABC-DNA end labeling technique to detect the apoptosis, a double immunohistochemical ABC- in situ hybridization technique to detect the expression of kappa mRNA and lambda mRNA, and a multiple mark techniques to detect the distribution of background non-neoplastic T and B cells.. Of 62 CHL, 14 (22.58%) were p53 positive and 35 (56.45%) bcl-2 positive. Apoptosis was found in the background non-neoplastic cells in all of the cases, but in H/RS cells in only 10 of 62 cases. There was a significant reverse correlation between bcl-2 expression and apoptosis in H/RS cells (P = 0.02). CD30 positive H/RS cells were observed in all cases, whereas CD15 positive in only 41 cases, and CD20 positive in 8 cases. None was positive for CD3, MPO, bcl-6, CD10, kappa RNA and lambda RNA in H/RS cells. The H/RS cells were surrounded by non-neoplastic T cells looked like a rosette and the outer periphery was B cells.. The H/RS cell of classical Hodgkin lymphoma has a great variety of B lineage markers. The characteristic distributions of T, B and H/RS cells may serve as a reference for the diagnosis. Multiple marker technique is able to highlight the critical cells, and facilitate the study of H/RS cells. Abnormal expression of P53 may not play a major role in CHL. Over expression of bcl-2 may be linked to blockage of apoptosis in CHL.

Topics: Adolescent; Adult; Aged; Antigens, CD20; Apoptosis; Biomarkers, Tumor; CD3 Complex; Child; Child, Preschool; Hodgkin Disease; Humans; Immunohistochemistry; In Situ Hybridization; In Situ Nick-End Labeling; Ki-1 Antigen; Lewis X Antigen; Middle Aged; Neprilysin; Proto-Oncogene Proteins c-bcl-2; Reed-Sternberg Cells; Tumor Suppressor Protein p53; Young Adult

The characteristic histologic features and immunophenotype are usually diagnostic and allow distinguishing CD30 positive T-cell lymphoma (including anaplastic large cell lymphoma) from classical Hodgkin's lymphoma. The latter differs by expression of CD15 and lack of CD45, pan-T antigens and ALK expression. We report nine cases of large cell hematopoietic neoplasms in which the neoplastic cells co-expressed CD30 and CD15, and had immunophenotypic and morphologic features of T-cell lymphoproliferative process. The average age of the CD15-positive group was 61.9 years; 6 cases occurred in men and 3 in women. The tumors were located in lymph nodes in 8 cases, and in liver in 1 case. Two cases expressed ALK protein. There were no statistically significant differences in phenotypic parameters between the CD15-positive and CD15-negative neoplasms (p>0.05). However, the CD15-positive group appeared to show a minor trend toward less positivity for EMA (44% versus 72%), ALK protein (22% versus 51%), and CD45RO (33.3% versus 83.3%, p=0.07), when compared to the typical CD15-negative neoplasms. In summary, although the co-expression of CD30 and CD15 is typical for classical HL, it may be also present in a subset of peripheral T-cell neoplasms including ALK-positive anaplastic large cell lymphoma. Combined and sensible use of morphology and a broad immunophenotypic panel in cases with limited material and/or those with overlapping histologic patterns will best discriminate between HL and ALCL. It is incumbent upon the pathologist to distinguish between these two clinicopathologic entities, since treatment options and clinical outcomes differ.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alkaline Phosphatase; Antigens, CD; Antigens, Neoplasm; Biomarkers, Tumor; Diagnosis, Differential; Female; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Lymphoma, T-Cell; Male; Middle Aged; Mucin-1; Neoplasm Proteins; Retrospective Studies

The perianal region is a very rare location for Hodgkin's lymphoma, and clinicians may often neglect the diagnosis in patients with inflammatory bowel disease.. We present a case of perianal Hodgkin's lymphoma in patient with Crohn's disease who was on long-term immunosuppression and whose symptoms would normally be attributed to Crohn's disease. Diagnosis was based on the morphological appearance of atypical cells in the lamina propria and the immunohistochemical profile of Reed Sternberg and Hodgkin's cells, showing co-expression of CD15 and CD30.. Perianal complaints in patients with inflammatory bowel disease may be a manifestation of other pathology. Hodgkin's lymphoma could be a progression in the chronically inflamed tissue in this unusual location.

Topics: Aged; Anus Neoplasms; Crohn Disease; Female; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen

Neoplastic cells in classical Hodgkin's lymphomas (cHL) seem to correspond to defective germinal center B-cells, which escape from apoptosis. Epstein-Barr virus (EBV) may be implicated in this protective mechanism. The aim of the present study was to determine the expression of apoptosis-related proteins in cHL among adult patients and correlate them with EBV expression, clinical findings and survival. EBV was detected by in situ hybridization (Epstein-Barr Encoded RNA, EBER, probe). Immunohistochemistry was used on paraffin sections to detect LMP-1/EBV, CD15 and the apoptosis-related proteins (bcl-2, bax, bcl-X, mcl-1 and CD95). Seventy-eight patients seen at our Institution were studied: 36 male and 42 female. Median age was 31 years (15-75 years). Histological types of cHL were: 61 nodular sclerosis (47 NS1 and 14 NS2), 15 mixed cellularity (MC), 1 lymphocyte depletion and 1 unclassified. In 50 cases there was EBV expression (64%). At least one apoptosis-associated protein was expressed in 92% and CD15 in 57.7% of the cases. In the univariate analysis, the following variables were related to a better overall survival: expression of CD15 (p = 0.023), expression of mcl-1 protein (p = 0.029), expression of bcl-2 protein (p = 0.028, only in a Cox model after stratification for histology) and expression of LMP-1 (p = 0.042). EBV expression presented a borderline inverse correlation with bcl-2. A prognostic index (PI) developed in the present study revealed that simultaneous expression of bcl-2, mcl-1 and LMP-1 was significant and independently correlated with an excellent survival.

Topics: Adolescent; Adult; Aged; Apoptosis; bcl-2-Associated X Protein; bcl-X Protein; Biomarkers; Epstein-Barr Virus Infections; fas Receptor; Female; Hodgkin Disease; Humans; Lewis X Antigen; Life Tables; Male; Middle Aged; Myeloid Cell Leukemia Sequence 1 Protein; Neoplasm Proteins; Prognosis; Proportional Hazards Models; Proto-Oncogene Proteins; Proto-Oncogene Proteins c-bcl-2; Retrospective Studies; RNA, Viral; Survival Analysis; Tumor Virus Infections; Viral Matrix Proteins

We report a rare case of primary pulmonary Hodgkin's lymphoma associated with Epstein-Barr virus (EBV) and cytomegaly virus (CMV) infections as demonstrated by in situ hybridisation method. Reed-Sternberg cells were CD30 positive. Numerous CD15+ cells were noticed, some of them with concomitant CMV infection.

Topics: Cytomegalovirus; Cytomegalovirus Infections; Diagnosis, Differential; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Lung Neoplasms; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Lymphoma, T-Cell; Middle Aged; Reed-Sternberg Cells; Tomography, X-Ray Computed

This is a case report of a young patient who experienced an acute epidural compression of cauda equina revealing Stage IV Hodgkin's disease.. To draw attention to this rare presentation of Hodgkin's disease, and to assess the role of surgery in acute cauda equina compression in a context of a chemosensitive disease.. Lymphomatous tissue in Hodgkin's disease may involve the spine usually in the setting of advanced disease. Initial manifestation of Hodgkin's disease in the spine is rare. The management of this rare presentation may be conservative, but surgery provides the most rapid way of neurologic tissue decompression.. The case of a 14-year-old patient who experienced an acute epidural compression of cauda equina revealing Stage IV Hodgkin's disease is presented.. The patient complained of an increased lower back pain of 1-month duration before he developed lower limbs numbness, loss of perineal sensation, and urinary retention. Sagittal and axial T2-weighted magnetic resonance images of the lumbar spine revealed tumoral invasion of the epidural space compressing the cauda equina. Emergency surgical decompression was performed. In fine, Stage IV Hodgkin's disease revealed by acute epidural cauda equina compression was diagnosed. The patient recovered normal neurologic functions in a few days and then underwent chemotherapy and radiotherapy.. Although a rare situation, Hodgkin's disease may involve the spinal epidural space at presentation. The management is complex, but surgery provides the most rapid means of diagnosis and neurologic tissue decompression in severely affected patients.

Topics: Acute Disease; Adolescent; Cauda Equina; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Low Back Pain; Male; Nerve Compression Syndromes; Treatment Outcome

Topics: Diagnosis, Differential; Granuloma; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; Orchitis; Recurrence; Sarcoidosis

The CD15 (Lewis x) cell surface oligosaccharide moiety is expressed in a variety of normal and tumor cells and recognized by selectins. The detection of CD15 on malignant Hodgkin-Reed-Sternberg (HRS) cells serves as a diagnostic marker of Hodgkin's lymphoma (HL). Retrospective studies suggest that the expression of nonsialylated CD15 molecules on HRS cells has a positive prognostic value while presence of sialylated CD15 may correlate with a poor outcome. However, the relevance of the CD15 antigen expression to the pathobiology of the disease is not clear. In this work, we studied the contribution of CD15 to cell adhesion and the activation of signaling cascades in two HL-derived cell lines, KMH-2 and L428.. Immobilized anti-CD15 monoclonal antibodies and recombinant E- and P-selectins were used to activate KMH-2 and L428 cells. Immunoblotting, immunoprecipitation, and the electrophoretic mobility shift assay were performed to detect tyrosine phosphorylation of c-Cbl, c-Jun nuclear translocation, and AP-1 DNA binding.. Treatment of cells with antibodies against the sialylated and nonsialylated forms of CD15, or with immobilized selectins, induced changes in cell morphology. Tyrosine phosphorylation of c-Cbl, together with tyrosine phosphorylation of multiple protein substrates, was also induced. In addition, binding of the CD15 molecules induced nuclear translocation of c-Jun and an increase in AP-1 DNA binding activity.. We suggest that CD15 has a dual physiological role, both as an adhesion molecule recognized by selectins and as a regulatory molecule upstream to specific intracellular signaling cascades with implications to the pathogenesis of HL.

Topics: Cell Adhesion; Cell Line, Tumor; DNA; E-Selectin; Hodgkin Disease; Humans; Lewis X Antigen; P-Selectin; Phosphorylation; Proto-Oncogene Proteins; Proto-Oncogene Proteins c-cbl; Proto-Oncogene Proteins c-jun; Signal Transduction; Transcription Factor AP-1; Tyrosine; Ubiquitin-Protein Ligases

Coexpression of CD30 and CD15 is typically associated with classic Hodgkin's lymphoma (HL). Peripheral T-cell lymphomas (PTCLs) can often display histologic features that simulate classic HL. However, reports of PTCLs coexpressing both CD30 and CD15 have been infrequently described. We report 11 cases of PTCL in which at least a subset of the neoplastic cells coexpressed CD30 and CD15. The patients included 4 women and 7 men and age ranged from 43 to 83 years (median, 62 years). Nine of 10 patients had advanced stage III or IV disease at presentation. Nodal involvement predominated in 8 of 11 patients, whereas 2 patients presented primarily with skin involvement. Two distinct groups were identified based on morphologic and immunophenotypic features. The first group of 5 cases had histologic features mimicking classic HL with CD30+, CD15+ Reed-Sternberg (RS)-like cells in an inflammatory background of varied extent and composition. The background lymphoid cells showed minimal cytologic atypia. The RS-like cells were negative for CD20 and CD79a in all cases, and CD45 expression was absent in 4 of 5 cases. The RS-like cells expressed CD25 and at least one T-cell-associated marker in all cases. The background T-cell population showed convincing subset predominance in 4 of 5 cases and loss of T-cell-associated antigens in 3 of 5 cases and coexpression of CD30 and CD15 in one case. The second group of 6 cases had morphologic features more in keeping with PTCL than classic HL. The proportion of neoplastic cells coexpressing CD30 and CD15 varied. Loss of T-cell antigens was noted in all cases and CD4 predominated in 4 of 5 cases. Three of the 6 cases expressed CD45. PCR analysis revealed clonal T-cell receptor gamma (TCR-gamma) chain gene rearrangements in 9 of 11 cases, but no immunoglobulin heavy (IgH) chain gene rearrangements. In situ hybridization studies for Epstein-Barr virus were negative in all cases. In some PTCL cases, the overlap with classic HL can be striking, and combined immunophenotypic and molecular studies are often necessary to confirm the diagnosis.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Viral; Diagnosis, Differential; Female; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; Hodgkin Disease; Humans; Immunophenotyping; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Lymphoma, T-Cell, Peripheral; Male; Middle Aged; Polymerase Chain Reaction

Large cell lymphomas and Hodgkin disease may develop during the course of chronic lymphocytic leukemia (CLL). In some cases the transformed cells are Epstein-Barr virus (EBV)-positive and not clonally related to the CLL cells. In other cases the transformed cells have the same clonal rearrangements as the CLL cells. Here we describe a composite lymphoma in a patient with CLL that exhibits a combination of CLL/small lymphocytic lymphoma, large cell lymphoma with anaplastic morphology, and Hodgkin lymphoma (HL). Although the large cell lymphoma cells are CD45R0 and TIA-1-positive, suggesting a T- or 0-cell anaplastic large cell lymphoma (ALCL), the genetic analysis demonstrates immunoglobulin heavy chain (IgH) gene rearrangements for both alleles, carrying the same somatic mutations as observed in the CLL component. The Reed-Sternberg (R-S) cells in the Hodgkin component also strongly express TIA-1 but differ from the anaplastic large cells by the expression of CD15 and TARC and the presence of a prominent lymphocytic infiltrate. The ALCL and HL components both are EBV negative. Analysis of the IgH gene rearrangements in micromanipulated R-S cells revealed identical Ig gene rearrangements carrying the same somatic mutations as the CLL and the large cell components. The findings indicate transformation of the CLL cells into a large cell lymphoma with anaplastic morphology and a Hodgkin component.

Topics: Aged; Base Sequence; Cell Transformation, Neoplastic; Chemokine CCL17; Chemokines, CC; Clone Cells; Gene Rearrangement, B-Lymphocyte, Heavy Chain; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunoglobulin Heavy Chains; Immunophenotyping; Leukemia, Lymphocytic, Chronic, B-Cell; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Male; Membrane Proteins; Molecular Sequence Data; Mutation; Poly(A)-Binding Proteins; Proteins; Reed-Sternberg Cells; RNA-Binding Proteins; T-Cell Intracellular Antigen-1

The atypical cells of CD30(+) cutaneous lymphoproliferative disorders (CD30CLD) are commonly of T-cell origin and frequently have a similar morphology as Hodgkin or Reed-Sternberg cells of Hodgkin's lymphoma (HL). HL is one of the tumors associated with CD30CLD. Although most studies support a B-cell derivation of the tumor cells in HL, recently a few cases of classical HL with T-cell genotype have been reported. We report a patient who presented with CD30CLD whose lymph nodes showed classical HL of mixed cellularity subtype at presentation. By single-cell PCR, the same clonal gene rearrangements of the T cell receptor-beta gene locus could be assigned to the CD30(+) and CD15(+) cells of both skin and lymph node. In a lymph node biopsy specimen taken in relapse after several courses of chemotherapy, the CD30(+) tumor cells were abundant. The T cell-derived tumor cells displayed aberrant expression of the Pax-5 gene in all specimens. A common clonal origin of both CD30CLD and HL of the lymph node in the patient presented here suggests that HL with T-cell genotype exists in association with CD30CLD as well as in sporadic cases and may share clonal origin with the skin tumor.

Topics: DNA-Binding Proteins; Female; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphoma, T-Cell; Lymphoproliferative Disorders; Middle Aged; PAX5 Transcription Factor; Polymerase Chain Reaction; Skin Diseases; Transcription Factors

Diagnosis of Hodgkin lymphoma (HL) by fine-needle aspiration (FNA) is often hampered by aspirated blood that camouflage scattered Hodgkin cells and Reed-Sternberg (HRS) cells, and the absence of HRS cells in the smears submitted for immunophenotyping. The objective of this study was to develop a simple protocol to overcome these problems. The visibility of HRS cells in Diff-Quik, traditional, and Ultrafast Papanicolaou (UFP) stains in FNA smears were compared in 73 cases of HL. HRS cells were found to be most visible in UFP because of the hemolysis of aspirated blood and the highlighting of HRS cells by the red-staining nucleoli. UFP-stained smears containing HRS cells were subsequently immunophenotyped via the cell-transfer technique. UFP staining was found to have no deleterious effect on the immunoreactivity of cellular CD15 and CD30 antigens of HRS cells. This simple protocol enhances the cytologic diagnosis of HL, feasible even with a single smear.

Topics: Azure Stains; Biopsy, Needle; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Methylene Blue; Reed-Sternberg Cells; Staining and Labeling; Xanthenes

Primary Hodgkin lymphoma of the gastrointestinal tract is exceedingly rare to the point that some authors regard with skepticism the existence of this entity. Cases of gastrointestinal Hodgkin lymphoma have been reported previously; however, most of these cases represented secondary involvement of the digestive tract in the context of systemic disease. Other cases have been reclassified in retrospective studies as non-Hodgkin lymphomas after the application of immunohistochemical techniques. We report a case of primary Hodgkin lymphoma of the gastrointestinal tract in a patient who presented with obstructive symptoms at the site of a gastroileal bypass; the bypass had been performed years earlier because of morbid obesity. Some non-Hodgkin lymphomas may morphologically mimic Hodgkin lymphoma and vice versa; therefore, an accurate pathologic diagnosis is important, since the therapeutic approach and prognostic implications differ significantly for these diseases. In this context, immunohistochemistry should be used to confirm or to exclude the histologic diagnosis of Hodgkin lymphoma.

Topics: Esophageal Neoplasms; Hodgkin Disease; Humans; Ileal Neoplasms; Immunohistochemistry; Lewis X Antigen; Male; Middle Aged; Stomach Neoplasms

Human immunodeficiency virus-associated Hodgkin lymphoma frequently involves the bone marrow and is usually recognized at staging after Hodgkin lymphoma diagnosis on a lymph node or other tissue biopsies, but occasionally the marrow involvement is the only apparent manifestation of disease. In the latter setting, diagnosis can be problematic. From a total of 42 patients with newly diagnosed human immunodeficiency virus-associated Hodgkin lymphoma, 22 subjects had positive marrow involvement at diagnosis; 16 of them had additional substantial histological and/or clinical extramedullary Hodgkin lymphoma. In the remaining 6 patients the bone marrow was the only site of disease at diagnosis. In all six cases, bone marrow biopsy revealed obvious lymphomatous involvement. Reed-Sternberg cells were identified both morphologically and immunophenotypically in all cases. Spared marrow tissue consistently showed fibrosis. All patients were males with a median age of 35 years (range, 31-58 years). All presented with fever, blood cytopenias, and severe CD4+ lymphocyte depletion (median, 70 cells/mm(3)). After diagnosis, all staging procedures were negative, and all patients were treated with chemotherapy. Median survival was 4 months (range, 2-118 mo). Longer survival was achieved in the patients who completed chemotherapy regimens; three subjects, however, died shortly before the full completion of chemotherapy, two of them from Hodgkin lymphoma. Isolated bone marrow HIV-associated Hodgkin lymphoma may be an underestimated condition in HIV-infected patients; in those individuals with unexplained fever and blood cytopenias, bone marrow biopsy should be performed with the aim of assessing for Hodgkin lymphoma, even in the absence of nodal and visceral lymphomatous involvement. A rapid diagnosis of isolated bone marrow HIV-associated Hodgkin lymphoma could expedite therapy.

Topics: Adult; Bone Marrow; Fatal Outcome; Herpesvirus 4, Human; HIV Infections; Hodgkin Disease; Humans; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; RNA, Viral

To explore the expression of B-cell-specific activator protein (BSAP) of H/RS cell in classical Hodgkin's lymphoma (cHL).. Immunohistochemical method was used to detect the expression of BSAP in 33 samples of formalin-fixed, paraffin-embedded tissues of cHL. Nine samples of lymph node of reactive hyperplasia, 10 samples of B-cell lymphoma, and 10 samples of T-cell lymphoma were also detected as BSAP controls. Mouse-anti-human monoclonal antibodies CD20, CD30 and CD15 were detected among the cHL cases as routine comparison.. 30 of 33 (90.91%) cases of cHL were BSAP expression positive in H/RS cells, while all of the 33 (100%) cases of background B-lymphocytes were BSAP positive. Almost all B cells of lymph node reactive hyperplasia were BSAP positive. All malignant cells in B-cell lymphoma were BSAP positive, while all malignant cells in T-cell lymphoma were BSAP negative. Among the 33 cases of cHL there was a significant difference between the expression of BSAP and the expression of CD20 (30.30%) in H/RS cells (P = 0.000), and no significant difference between the expression of CD30 (93.94%) and CD15 (75.75%, P = 0.082).. The frequent expression of BSAP in H/RS cells of classical Hodgkin's disease provides further evidence for its B-cell origin and helps to identify H/RS cells. The expression of BSAP in H/RS cells can be used to distinguish HL from anaplastic large cell lymphoma (ALCL).

Topics: Adolescent; Adult; Antigens, CD20; Child; Child, Preschool; Diagnosis, Differential; DNA-Binding Proteins; Female; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large-Cell, Anaplastic; Male; PAX5 Transcription Factor; Reed-Sternberg Cells; Transcription Factors

Paraffin blocks and clinical data from 521 patients with lymphocyte predominance Hodgkin disease (LPHD) diagnosed between 1970 and 1994 were collected from 16 European and United States oncological centers to establish the pathologic and clinical characteristics of a large patient cohort, to determine how frequent T-cell-rich large B-cell lymphoma (TCRLBCL) is among LPHD, and to find differential diagnostic criteria distinguishing between the 2 lymphoma categories. For this purpose, conventionally and immunohistologically stained sections were reviewed by a panel of hematopathologists. The diagnosis of LPHD was confirmed in only 219 of the 388 assessable cases (56.5%). This low confirmation rate was due mainly to the presence of a new variant of classical Hodgkin disease (CHD), which resembled, in terms of nodular growth and lymphocyte-richness, nodular LPHD and, in terms of the immunophenotype of the tumor cells, CHD and was designated nodular lymphocyte-rich CHD (NLRCHD). The nodules of LRCHD consisted-as in nodular LPHD-predominantly of B cells but differed from those present in LPHD in that they represented expanded mantle zones with atrophic germinal centers. Clinically, patients with LPHD and NLRCHD showed similar disease characteristics at presentation but differed in the frequency of multiple relapses and prognosis after relapse. Patients with LPHD and NLRCHD clearly differed from patients with CHD with nodular sclerosis or mixed cellularity, as they presented with an earlier disease stage and infrequent mediastinal involvement. As 97% of the LPHD cases showed a complete or partial nodular growth pattern, their differentiation from TCRLBCL was a rare problem in the present series. (Blood. 2000;96:1889-1899)

Topics: Adolescent; Adult; Antigens, CD20; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Lymphocytes; Lymphoma; Male; Middle Aged; Neoplasm Staging; RNA, Viral; Survival Analysis

CD15 expression has been used for years to confirm the diagnosis of Hodgkin's disease (HD). Little is, however, known on the relevance of the CD15 antigen to the pathobiology of the disease and there is conflicting evidence as to the prognostic value of its expression. To investigate the significance of the differential expression of CD15 in Hodgkin's disease, a retrospective study of 102 patients with "classical" Hodgkin's disease was performed. Immunohistochemical studies were carried out using antibodies against two types of CD15: non-sialylated CD15 (LeuM1 and 80H5) and sialylated CD15 (FH6 and CSLEX1). Cases that were negative for non-sialylated CD15 or positive for the sialylated variant were stained again following neuraminidase pretreatment. The cohort included 27 patients in whom sequential biopsies were available. Both CD15 expression in its non-sialylated form and absence of sialyl-CD15 expression correlate with a favorable outcome. Subsequent biopsies show a preferential expression of sialyl-CD15, notably in bone marrow metastases. Our findings suggest that, in the progression of HD towards a widely disseminated disease, the LewisX moiety of the CD15 antigen on the tumor cells acquires a sialyl-group. This change may confer on the tumor cells the capacity to metastasize.

Topics: Actuarial Analysis; Adolescent; Adult; Aged; Antibodies, Monoclonal; Biomarkers; Child; Child, Preschool; Female; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Male; Middle Aged; Prognosis; Reed-Sternberg Cells; Retrospective Studies; Sialoglycoproteins; Survival Rate

Extranodal Hodgkin disease presenting as a primary localized neoplasm is uncommon, with rare case reports describing primary sites other than lymph nodes. The gastrointestinal tract is the most frequent site of involvement by extranodal Hodgkin disease, typically involving the stomach or small bowel. To date, we have been able to find only one fully documented case of Hodgkin disease of the sigmoid colon confirmed by immunohistochemical studies. We report a case of extranodal Hodgkin disease involving the transverse colon, presenting as inflammatory bowel disease and documented by light microscopic, immunohistochemical, cytogenetic, and molecular studies.

Topics: Adult; Colonic Neoplasms; Female; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Vimentin

Topics: Adult; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Male

Large B-cell lymphoma manifesting in the mediastinum shows distinctive clinical and immunophenotypic features and is recognized as a unique type of large B-cell lymphoma in the Revised European-American Lymphoma classification. Fifty-one cases of primary mediastinal large B-cell lymphoma were retrieved from the immunodiagnosis laboratory database files and were stained with anti-CD30 (Ber-H2). Of the 51 cases, 35 (69%) stained for CD30. This staining ranged from strong membrane staining of all or almost all of the neoplastic cells to positivity of rare individual cells. Eleven cases (22%) were negative; 4 (8%) were equivocal. Only 1 case was uninterpretable owing to B-5 fixation and lack of a positive internal control. Thus, the majority of mediastinal large B-cell lymphomas express the Hodgkin marker CD30. This finding may result in misdiagnosis of large cell lymphoma as Hodgkin disease.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Diagnosis, Differential; Female; Hodgkin Disease; Humans; Immunoenzyme Techniques; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Male; Mediastinal Neoplasms; Middle Aged

The utility of staining Reed-Sternberg (RS) cells with CD30, CD15 and CD45 as a diagnostic aid in Hodgkin's disease (HD) and the value of microwave citrate antigen retrieval (AR) method in improving the results of immunohistochemical (IHC) studies were evaluated. Histological and immunohistological studies were carried out on 21 patients with HD seen from January 1987 to December 1996 in the Pathology Department of the Cumhuriyet University, School of Medicine. Avidin biotin peroxidase complex (ABC) was used in IHC study as a method for detection of RS cells. Monoclonal antibodies CD30, CD15 and CD45 were applied on formalin fixed paraffin embedded tissue sections. In order to enhance the immunoreactivity, microwave citrate AR method and proteolytic pretreatment were used. The reactivity of RS cells and staining patterns were determined. In 14 (70%) of the 20 patients, RS cells stained positively with CD30, in 16 (80%) CD15 staining was positive and only 1 (5%) was positively stained with CD45. A combination of cytoplasmic with cell surface staining was common with CD30, while paranuclear deposit with cell surface and cytoplasmic staining was common with CD15. In conclusion, to facilitate the detection of RS cells in formalin fixed paraffin embedded tissues, the application of a panel of markers appears to be necessary. Also AR method seems to be helpful in obtaining optimal results on formalin fixed paraffin embedded tissue.

Topics: Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Microwaves

To investigate the clinicopathological characteristics of nodular lymphocyte predominance Hodgkin's disease.. Eleven samples of paraffin embedded lymph node and one of frozen lymph node from nodular lymphocyte predominance Hodgkin's disease patients were studied. HE staining, immunohistochemistry for CD3, CD19, CD20, CD30, CD45RB, kappa and lambda light chain and single L&H cell polymerase chain reaction (PCR) were performed.. The diagnosis of nodular lymphocyte predominance Hodgkin's disease was established by the identification of characteristic L&H cells in the nodular small lymphocytes and histiocytes background. L&H cells expressed CD19(10/12), CD20(12/12), CD45RB(12/12) and kappa light chain (11/12). IgH and V kappa 4 family gene rearrangements were detected in the single L&H cell. Eight of the patients survived more than 5 years.. Nodular lymphocyte predominance Hodgkin's disease has a very slow disease course and a better prognosis. It is a malignant lymphoma derived from B cells.

Topics: Adolescent; Adult; Aged; Antigens, CD20; Child; Female; Follow-Up Studies; Hodgkin Disease; Humans; Immunoglobulin kappa-Chains; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Male; Middle Aged

The topoisomerase II alpha (topo II alpha) enzyme is the target for several chemotherapeutic agents, including etoposide, teniposide, mitoxantrone, and doxorubicin (topo II poisons). The enzyme also is a marker of cell proliferation. Most cases of Hodgkin's disease (HD) are responsive to combination chemotherapy regimes that include topo II poisons such as doxorubicin. Immunoperoxidase methods for detection of the topo II alpha isoenzyme are now available for use in formalin-fixed, paraffin-embedded tissues, which may provide information about the proliferative capacity and possible sensitivity of tumors to drugs that target topo II. We used a specific antibody to analyze subsets of HD for topo II alpha staining patterns. Formalin-fixed blocks from 49 cases of HD, including 20 nodular sclerosis (NS), 14 mixed-cellularity (MC), and 15 lymphocyte-predominant (LP) subtypes, were analyzed by dual staining for topo II in combination with monoclonal antibodies against Reed-Sternberg (RS) cells consisting of CD15 for the NS and MC subtypes and CD20 for LP lymphocytic and histiocytic (L & H) cells. The number of morphologically appropriate cells coexpressing the RS or L & H marker and topo II alpha was quantitated. Positive nuclear staining for topo II alpha in RS or L & H cells was seen in 100% of cases, irrespective of subtype. Coexpression of CD15 and topo II alpha was seen in 58.4% of the RS cells or mononuclear variants in NSHD cases and 68.4% in MCHD cases. No significant difference in the percentage of neoplastic cells expressing topo II alpha was found between NS and MC subtypes. Cases of LPHD showed coexpression of CD20 and topo II alpha in 84.4% of the L & H cells, a significant increase over the level of tumor cell coexpression seen in NSHD and MCHD (P < .001). Only one case was found to have a low (< 25% of tumor cell coexpression) level of topo II alpha expression. Immunohistochemical detection of a high level of topo II alpha expression in HD, irrespective of subtype, suggests a molecular explanation for the excellent response of most HD to standard combination chemotherapy, which can include topo II poisons. The LP subtype has a higher expression of topo II alpha in the neoplastic cell population than do NS or MC subtypes, perhaps indicating increased sensitivity of these tumors to topo II poisons. It may be possible to identify subsets of HD that are more or less sensitive to conventional chemotherapeutic regimes, which would help in the selection

Topics: Antigens, CD20; Antigens, Neoplasm; DNA Topoisomerases, Type II; DNA-Binding Proteins; Hodgkin Disease; Humans; Immunohistochemistry; Isoenzymes; Lewis X Antigen; Lymphocytes; Reed-Sternberg Cells

The lymphoid tissues of Waldeyer's ring, including the nasopharynx, are very rare sites for Hodgkin's disease and are considered to be relatively resistant to it. This report of a case of Hodgkin's disease of the post-nasal space demonstrates the difficulty of making the diagnosis histologically and the characteristic immunohistochemical features of this disease. Before immunohistochemistry became so widely available, some authors speculated it might be underdiagnosed (Eavey and Goodman, 1982; O'Reilly and Kershaw, 1987). Judging by its continued rarity, this appears not to be the case.

Topics: Cell Membrane; Cell Nucleus; Cytoplasm; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Male; Middle Aged; Nasopharyngeal Neoplasms; Reed-Sternberg Cells

Diagnosis of Hodgkin's disease (HD) is quite difficult in the patient with seropositivity for human T cell lymphotropic virus I (HTLV-I). Herein, two cases of Epstein-Barr virus (EBV)-associated HD, which occurred in males with seropositivity for anti-HTLV-I, are reported. One patient is alive and was diagnosed as having interfollicular HD with CD20+CD15-CD30-CD3-CD4-CD8-CD45RO-Read-Sternberg (R-S) cells. Positivity for EBV-encoded RNA 1 (EBER-1) and latent membrane protein 1 (LMP-1) was shown on follicular germinal center cells and R-S cells. In that case, neither T cell receptor (TCR) beta chain rearrangement nor integration of the HTLV-I provirus was demonstrated in the lymph nodes, although atyical lymphocytes (2%) were found in the peripheral blood. The other case pursued an aggressive clinical course and the patient was diagnosed as having an adult T cell leukemia/lymphoma (ATLL) because of the presence of anti-HTLV-I antibody, lymph node swelling, and the appearance of flower-like cells in the peripheral blood. However, an autopsy revealed no obvious ATLL cell infiltration in any of the organs examined. Multiple granulomatous lesions were found in the bone marrow, liver, kidneys, spleen, and lymph nodes. Reassessment of lymph node lesions in biopsies and granulomatous lesions in autopsy samples demonstrated that both lesions contained CD15+CD30+CD3-CD4-CD8-CD20-CD45RO-EBER-1+L MP-1+R-S cells, and they were considered to be a composite lymphoma of HD and ATLL. These two cases therefore suggest that EBV-associated HD can develop in patients with seropositivity for HTLV-I.

Topics: Antigens, CD; Fatal Outcome; Herpesviridae Infections; Herpesvirus 4, Human; Hodgkin Disease; HTLV-I Infections; Humans; Immunohistochemistry; In Situ Hybridization; Lewis X Antigen; Lymph Nodes; Male; Microscopy, Electron; Middle Aged; Polymerase Chain Reaction; Reed-Sternberg Cells; RNA, Viral; Tumor Virus Infections

Hodgkin disease (HD) is characterized by a small number of malignant Hodgkin and Reed-Sternberg (H/RS) cells among a major population of nonmalignant cells. The analysis of H/RS cells has been hampered by their low frequency and fragility. Here, we describe the isolation of viable H/RS cells from HD affected tissues by high gradient magnetic cell sorting (MACS) according to expression of CD30. The cells were enriched to a purity of up to 50%. H/RS cells were distinguished from other CD30(+) cells by the expression of CD15, their size and granularity. No CD30/CD15 double-positive cells could be enriched from a lymph node affected by the lymphocyte predominant subtype of HD, activated lymph nodes or peripheral blood of healthy donors. For two cases of HD individual MACS-purified H/RS cells and H/RS cells micromanipulated from tissue sections of the same lymphoma specimens were analyzed for Ig gene rearrangements. In both cases, identical V gene rearrangements were amplified from both sources of H/RS cells, showing that H/RS cells were successfully enriched. Moreover, the finding that in both cases no additional Ig gene rearrangements other than the ones identified in the H/RS cells micromanipulated from tissue sections were amplified from the MACS-purified H/RS cells further supports the monoclonality of these cells throughout the affected lymph nodes. The isolation of viable H/RS cells ex vivo is prerequisite for a direct study of gene expression by those cells and of their interaction with cells in their vicinity.

Topics: Adolescent; Adult; Aged; Cell Separation; Cell Size; Cell Survival; Female; Gene Rearrangement, B-Lymphocyte, Heavy Chain; Hodgkin Disease; Humans; Immunomagnetic Separation; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Male; Middle Aged; Molecular Sequence Data; Polymerase Chain Reaction; Reed-Sternberg Cells

Histologic features of recurrent Hodgkin's disease (HD) after conventional therapy are well known, but few studies describe HD after bone marrow transplantation (BMT). Histologic material from 63 patients who underwent BMT performed to treat recurrent nodular sclerosing HD (NSHD) between 1985 and 1994 was examined; 13 of the 63 patients had histologically proved recurrent disease after BMT. Histologic material and clinical findings from the original diagnostic biopsy specimen and pre-BMT and post-BMT specimens were available from our study population of eight patients (five male, three female; age range, 16 to 38 years; median age, 27.5 years). Seven patients had recurrent NSHD after BMT; sites of recurrence included lymph nodes only (four patients), and lymph nodes and lung, lung and liver, and lung only (one patient each). In one patient, a high-grade non-Hodgkin's B-cell lymphoma developed in the large intestine 5 years after BMT. In another, disease progressed from grade 1 in the original biopsy specimen to grade 2 in both the pre-BMT and post-BMT recurrent HD biopsy specimens. Post-BMT biopsy specimens of recurrent HD with lung involvement revealed a substantial increase in sclerosis and fibroblastic features. Paraffin immunoperoxidase studies in seven patients demonstrated substantial change in phenotype of Reed-Stemberg cell variants in only one post-BMT recurrent HD specimen, which showed a +2 reaction with CD30 (Ki-1). No substantial differences in the reactive component were noted between the original biopsy specimen and pre-BMT and post-BMT specimens of recurrent disease. In summary, histologic findings of post-BMT recurrent NSHD do not differ significantly from those of the original diagnostic biopsy or pre-BMT recurrent HD specimens. The lung is the most common site of extranodal post-BMT recurrence. In one patient, high-grade non-Hodgkin's B-cell lymphoma developed after BMT performed to treat recurrent HD.

Topics: Adolescent; Adult; Bone Marrow Transplantation; Female; Hodgkin Disease; Humans; Immunoenzyme Techniques; Ki-1 Antigen; Lewis X Antigen; Liver Neoplasms; Lung Neoplasms; Lymph Nodes; Male; Mediastinal Neoplasms; Mucin-1; Necrosis; Recurrence; Sclerosis

Inflammatory malignant fibrous histiocytoma (IMFH), consisting of large, atypical histiocyte-like cells set amidst an inflammatory backdrop of eosinophils, neutrophils, lymphocytes, and xanthoma cells, can be difficult to distinguish from Hodgkin's disease and non-Hodgkin's lymphoma, particularly of the Ki-1 anaplastic large-cell type in small biopsy specimens. This problem is becoming more prevalent with the use of needle biopsies guided by computed tomography for definitive diagnosis. For this reason, we studied the expression of a battery of leukocyte markers in IMFH to evaluate whether they could serve as an independently reliable means of distinguishing amongst the three neoplasms. Eight examples of histologically typical IMFH were stained with a number of leukocyte markers that included CD30 (BerH2), CD15 (leuM1), CD45/ CD45RB (2B11,PD7/26/16), CD43 (leu 22), CD45RO (A6), CD20 (L26), and CD68 (KPI). The large anaplastic tumor cells within IMFH consistently lacked CD30, CD15, CD45/CD45RB, CD43, CD45RO, and CD20. In one case, the anaplastic cells expressed CD68. Benign histiocytes within IMFH expressed CD68 and displayed variable expression of CD15, CD45/CD45RB, and CD43. The reactive lymphocytes consisted mostly of scattered small T cells with a few B cells, mainly within lymphoid aggregates. We conclude that the immunophenotypic profile of the anaplastic cells in IMFH (lack of CD15, CD30, CD43, CD45/CD45RB, CD45RO, CD20) differs from most cases of Hodgkin's disease (ICD30+, CD15+/-) and from Ki-1 anaplastic large cell lymphoma (CD30+, CD45/CD45RB+/-, CD43+/-, CD45RO+/-, CD20-/+). Immunohistochemistry is an important diagnostic adjunct, provided care is taken to exclude benign histiocytes and inflammatory cells from consideration.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers; Diagnosis, Differential; Female; Histiocytoma, Benign Fibrous; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Lymphoma, Non-Hodgkin; Male; Middle Aged; Retrospective Studies

We report a case of lymphoma associated with lung carcinoma that shows morphological and immunohistochemical features of anaplastic large cell Ki-1 positive lymphoma and Hodgkin's disease, with positivity for Ki-1 (CD-30) (characteristic of both lymphomas) and Leu-M1 (CD-15) (normally dosent absent in anaplastic lymphoma). This subtype of lymphoma is designated anaplastic large-cell Hodgkin's related lymphoma (ALCL related to HD) and is considered by some authors as a secondary anaplastic large-cell lymphoma.

Topics: Antigens, Neoplasm; Biomarkers, Tumor; Carcinoma, Squamous Cell; Diagnosis, Differential; Fatal Outcome; Hodgkin Disease; Humans; Ki-1 Antigen; Ki-67 Antigen; Lewis X Antigen; Lung Neoplasms; Lymphoma, Large-Cell, Anaplastic; Male; Middle Aged; Neoplasms, Multiple Primary

Previous studies have shown that in non-Hodgkin's lymphomas and others neoplasms, tumoral progression, treatment response, and outcome are related to the expression of different oncogenic and tumor suppressor proteins. This study aimed to determine the prognostic significance of the expression of p53, bcl2, retinoblastoma protein (Rb), Ki67, CD15, and latent membrane protein 1-Epstein-Barr Virus (LMP1-EBV) proteins in Hodgkin's disease. A retrospective study was performed on 140 patients collected at the 11 participating centers belonging to the Spanish Collaborative Group for the Study of Hodgkin's Disease. A highly sensitive immunohistochemical method with previous microwave-induced antigen retrieval technique was used for the demonstration of the above-mentioned proteins. A Cox's multivariate analysis was performed to evaluate the impact of the variables in the overall survival, together with a logistic regression model for the achievement of complete remission. Univariate statistical analysis confirmed the prognostic significance of the alredy known clinical parameters: stage, age over 60 years, and B symptoms. High proliferation index (Ki67) and loss of Rb expression were also found to be adverse prognostic factors influencing respectively lower overall survival and failure to achieve complete remission. Multivariate analysis confirmed the independent significance of these two parameters and additionally identifies LMP1-EBV expression as a favorable prognostic marker, in relation with overall survival. Histopathological type, p53, bcl2, and CD15 expression lack significant influence on the outcome of this series. The progression of the disease or the response to treatment in HD patients is the consequence of the interrelationship of different factors, among which LMP1 expression, loss of Rb, and high growth fraction seems to play a more relevant role.

Topics: Adolescent; Adult; Aged; Cell Division; Child; Child, Preschool; Female; Hodgkin Disease; Humans; Ki-67 Antigen; Lewis X Antigen; Male; Middle Aged; Multivariate Analysis; Prognosis; Proto-Oncogene Proteins c-bcl-2; Regression Analysis; Retinoblastoma Protein; Retrospective Studies; Survival Analysis; Tumor Suppressor Protein p53; Viral Matrix Proteins

Antibodies against CD15, -30, and -20 are often used to support morphological diagnosis of Hodgkin's Disease (HD). The classical HD, i.e., the non-lymphocyte-predominance types, are CD15+, CD30+, and CD20- in general. However, the results for CD15 are less clear-cut in many studies, showing up to 40% of classical HD that lack positivity for this maker. Little is currently known about the relevance of antigen expression in relation to clinical outcome in HD. Therefore, the three markers were analyzed in 1751 cases from the German Hodgkin Study Group, using micro-wave epitope retrieval to optimize staining sensitivity. Eighty-three percent of the cases showed a classical immunophenotype (CD15+, CD30+, CD20-), twelve percent lacked CD15 positivity (CD15-, CD30+, CD20-), and five percent showed other combinations. For 1286 cases, clinical follow-up was available, which revealed significant differences for freedom from treatment failure (P = 0.0022) and overall survival (P = 0.0001) between cases with classical immunophenotype and CD15 negativity (CD30+, CD20-). Multivariate Cox regression using the three markers, age, sex, histology, stage, B-symptoms (fever, sweats, weight loss > 10% of body weight), hemoglobin, and erythrocyte sedimentation rate as factors showed that lack of CD15 expression in classical HD is an independent negative prognostic factor for relapses (P = 0.022) and survival (P = 0.0035). In conclusion, immunohistochemistry is able to identify classical HD cases with unfavorable clinical outcome.

Topics: Adolescent; Adult; Aged; Antigens, CD20; Biomarkers; Female; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Male; Middle Aged; Reed-Sternberg Cells; Retrospective Studies; Survival Analysis

We describe the occurrence of malignant lymphoma as a possible complication of immunosuppression associated with low dose methotrexate (MTX) therapy for juvenile rheumatoid arthritis (JRA). A 6-year-old girl with systemic onset JRA who had received low dose MTX therapy for 16 months developed diffuse peripheral lymphadenopathy and enlargement of the lymph nodes in the mediastinum, hilum of the lungs, and liver. Lymph node histology disclosed mixed cellularity Hodgkin's lymphoma; the neoplastic cells were positive for CD30 and CD15, but negative for Epstein-Barr virus RNA or EBV latent membrane protein. After chemotherapy, the girl had complete remission of her disease lasting for 18 months; however, the disease relapsed and autologous peripheral stem cell transplantation was performed. Although the occurrence of lymphoma may be associated with autoimmune diseases, our observations suggest that in pediatric patients, the increasing use of low dose MTX therapy for JRA may be an additional factor for the development of lymphoproliferative disease.

Topics: Arthritis, Juvenile; Biopsy; Child; Female; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Methotrexate

We describe the histologic and immunohistochemical findings in specimens from bone marrow (BM) biopsies performed for staging purposes in 13 patients with a previous tissue-based diagnosis of T-cell-rich B-cell lymphoma (TCRBCL). Bone marrow involvement was found in 8 (62%) of 13 cases and was often paratrabecular. The histologic appearance was not pathognomonic of TCRBCL, with the differential diagnosis including Hodgkin's disease and peripheral T-cell lymphoma. The infiltrates typically had a pale low-power appearance (due to histiocytic infiltration, relative hypocellularity, or both) that, in conjunction with the presence of a polymorphous infiltrate of scattered large atypical cells amid a mixed infiltrate of small lymphocytes and histiocytes, was suggestive of Hodgkin's disease. Immunohistochemistry revealed CD20 reactivity of the large atypical cells with the absence of CD15 and CD30 reactivity, supporting the diagnosis of TCRBCL. A prominent small T-cell infiltrate accompanying the large atypical cells was observed in all positive BM biopsy specimens. The increased incidence of BM involvement in TCRBCL is significantly higher than that found in de novo B-cell diffuse large cell lymphoma, suggesting a possible biologic difference between the two entities. Our cases share some similar clinicopathologic features with histiocyte-rich B-cell lymphoma and with diffuse lymphocyte-predominant Hodgkin's disease, paragranuloma type. We discuss the possible relationship to these two entities.

Topics: Adult; Aged; Antigens, CD20; Biopsy; Bone Marrow; Cell Transformation, Neoplastic; Diagnosis, Differential; Female; Genotype; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphoma, B-Cell; Lymphoma, T-Cell; Male; Middle Aged; Survival Rate; T-Lymphocytes

A case of Hodgkin's disease (HD), lymphocyte depression (LD) type in an immunosuppressive patient is described. The patient was a 48-year-old male and his parents were born in the Kyushu area, which is an endemic area for adult T cell lymphoma/leukemia (ATL). He was seropositive for ATL virus (ATLV, also referred to as HTLV-I) and showed a marked immunosuppressive condition. He developed LD-HD and Pneumocystis carinii pneumonia, and died due to respiratory failure. The immunohistochemical and in situ hybridization analyses revealed that the Reed-Sternberg-like cells in the lymph node biopsy sample were positive for Ber-H2 (CD30), Leu-M1 (CD15), L-26 (CD20), Bcl-2, p53 and EBER, the viral genome of Epstein-Barr virus (EBV).

Topics: Antigens, CD20; Fatal Outcome; Herpesvirus 4, Human; Hodgkin Disease; HTLV-I Infections; Humans; Immunocompromised Host; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymph Nodes; Male; Middle Aged; Opportunistic Infections; Pneumonia, Pneumocystis; Proto-Oncogene Proteins c-bcl-2; Reed-Sternberg Cells; RNA, Viral; Tumor Suppressor Protein p53

We report Hodgkin's disease arising in a 68-year-old patient with a history of chronic lymphocytic leukemia for 8 years. The patient presented with a 4-month history of weakness, loss of appetite, and a 15-pound weight loss. A bone marrow biopsy showed two distinct histologic types of lymphoma: chronic lymphocytic leukemia and Hodgkin's disease. Immunohistochemical studies showed that chronic lymphocytic leukemia cells were composed of kappa-light chain-restricted monoclonal B cells. The Reed-Sternberg cells expressed CD15. Epstein-Barr virus RNA was not identified in either the Reed-Sternberg cells or cells of chronic lymphocytic leukemia by in situ hybridization. To our knowledge, this is the second reported case of composite Hodgkin's disease and chronic lymphocytic leukemia involving the bone marrow.

Topics: Aged; Antigens, CD20; Biopsy; Bone Marrow Neoplasms; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunoenzyme Techniques; Immunohistochemistry; In Situ Hybridization; Leukemia, Lymphocytic, Chronic, B-Cell; Lewis X Antigen; Neoplasms, Multiple Primary; Reed-Sternberg Cells; RNA, Viral

B-cell non-Hodgkin's lymphomas with a marked preponderance of reactive T cells, so-called T-cell rich B-cell lymphomas (TCRBCLs), can be morphologically confused with Hodgkin's disease (HD). To establish helpful distinguishing features in paraffin sections, 10 cases of L26-positive, CD15-negative HD and 10 cases of TCRBCL were compared; 4 cases of HD had morphologic features of the nodular lymphocyte predominant (LP) type. Nine of 10 cases of HD contained fewer than 20 mitoses/20 high power fields (hpf) and only 1 had pericapsular involvement. In contrast, 9 of 10 TCRBCL had greater than 20 mitoses/20 hpf and 7 had perinodal infiltration. HDLP was easily distinguished from TCRBCL by the expanded dendritic meshworks outlining the L & H nodules and the high content of CD57-positive lymphocytes. The remaining 6 cases of non-LP L26-positive HD had a relatively distinctive immunostaining pattern, with absence of CD45 and discordant reactivity for L26 and Ki-B5 in Reed-Sternberg cells and variants. Only 3 cases of TCRBCL had a similar CD45 and L26/Ki-B5 immunostaining pattern, and these could be distinguished by demonstrable cytoplasmic light-chain restriction. These results show that evaluation of the mitotic count, pericapsular involvement, and immunohistochemical staining patterns for Ki-M4p, CD57, L26/Ki-B5, and CD45 can help to discriminate TCRBCL from L26-positive HD when only fixed material is available.

Topics: Adult; Aged; Antigens, Neoplasm; Diagnosis, Differential; Female; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Lymphoma, B-Cell; Male; Middle Aged; T-Lymphocytes

We describe a 74-year-old man who presented with multifocal small bowel lesions, a large mesenteric mass, and enlarged mesenteric lymph nodes. In each of the extranodal sites and in two of three regional lymph nodes, there were classic histologic features of marginal zone B-cell lymphoma with adjacent areas of Hodgkin's disease, mixed cellularity subtype. Immunophenotypic analysis in the areas of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue showed immunoreactivity for CD45RB and CD20 in the malignant small cell population. Conversely, the areas of Hodgkin's disease demonstrated positive immunoreactivity for CD15 and CD30 in the Reed-Sternberg cells and variants. Latent membrane protein for Epstein-Barr virus was also positive in the Reed-Sternberg cells and variants.

Topics: Aged; Antigens, CD20; Antigens, Viral; Herpesvirus 4, Human; Hodgkin Disease; Humans; Ileal Neoplasms; Immunoenzyme Techniques; Immunophenotyping; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymph Nodes; Lymphatic Metastasis; Lymphoma, B-Cell, Marginal Zone; Male; Viral Matrix Proteins

The clinical histopathological and immunophenotypic features in 5 patients with Ki-1 positive non-Hodgkin's lymphoma (NHL) were studied. When first seen, 4 patients presented enlargement of superficial lymph nodes, with skin lesions in 2 patients. Two patients in stage IV with fever, hepato-splenomegaly and bone marrow invasion, died. Histologically, the tumor cells showed diffused or patchy hyperplasia. The cells were relatively large in size, rich in bosophilic or slightly eosinophilic cytoplasm with irregularly-shaped nuclei, prominent nucleoli, and distinct anaplasia and pleomorphism. Some of the cells looked very much like the Reed-Sternberg cells. Multinucleated giant cells were seen. Immunophenotypically, all the cells were CD30 (Ki-1) and CD25 (IL-2 receptor) positive but CD15 (Leu M1) negative. Thus, the 5 patient T Ki-1 positive NHL were all of T cell type.

Topics: Adolescent; Aged; Diagnosis, Differential; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Non-Hodgkin; Lymphoma, T-Cell; Male; Middle Aged; Receptors, Interleukin-2

The mouse monoclonal antibody anti-Leu-M1 (CD15) recognizes the carbohydrate determinant lacto-N-fucopentaose III, an oligosaccharide believed to be involved in cell-cell interactions. Anti-Leu-M1 is used in surgical pathology as an aid in the diagnosis of Hodgkin's disease. Additionally, adenocarcinomas derived from various organs stained positively with anti-Leu-M1 at the light microscopic level. Since mesotheliomas do not display positive reactivity to this antibody, Leu-M1 is clinically useful as part of a panel of antibodies in distinguishing adenocarcinomas from mesotheliomas. Previous work was carried out using post-embedding protein A-gold immunocytochemistry on thin sections embedded in Lowicryl K4M from a patient with Hodgkin's disease of the nodular sclerosing type; intense and precise labeling by gold particles was revealed in cytoplasmic granules, which were often clustered in a perinuclear location, in the Golgi apparatus, and focally along the plasma membrane of Reed-Sternberg cells. Moreover, polymorphonuclear leukocytes demonstrated similar labelling along the plasma membrane and over cytoplasmic granules. To define precisely the intracellular localization of Leu-M1 in human adenocarcinomas, we have performed post-embedding immunoelectron microscopy with the protein A-gold technique on sections embedded in Lowicryl K4M from neoplasms of the lung, stomach, colon, and breast. The pattern of labeling by gold particles indicative of Leu-M1 binding varied in adenocarcinomas of the different organs.

Topics: Adenocarcinoma; Antigens, Neoplasm; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Microscopy, Immunoelectron; Neoplasms; Neutrophils

Studies of skin involvement in Hodgkin's disease are infrequent in the literature. In particular, immunophenotypic analyses of specific cutaneous infiltrates have been performed in only a few cases. We analyzed the clinical, histological and immunohistochemical features of specific cutaneous manifestations of Hodgkin's disease comparing histologic and immunophenotypic aspects of skin lesions with those of the nodal counterpart. Seven patients with Hodgkin's disease of the lymph nodes and specific cutaneous lesions, where both nodal and skin biopsies were available for histologic and immunohistochemical analyses, were included in this study. Immunohistochemical stains were performed with a 3-step immunoperoxidase technique on routinely-fixed, paraffin-embedded tissue sections. All 7 patients had nodular sclerosis Hodgkin's disease of the lymph nodes. In the skin, clinical presentations included reddish-brown papules, plaques, nodules and ulcerated tumors. Histologic examination of cutaneous lesions showed features consistent with nodular sclerosis Hodgkin's disease in 6 cases and unclassifiable Hodgkin's disease in one. Reed-Sternberg cells and lacunar cells were present in 4 cases (57.1%). Immunohistochemical analysis of Hodgkin's and Reed-Sternberg cells revealed a constant positivity for CD30 (BerH2) and negativity for CD45 (LCA) in both the lymph nodes and the skin. Staining with CD15 (M1) revealed positivity in 7/7 nodal samples and 5/7 skin biopsies. Cytoplasmic expression of immunoglobulin light chains (both lambda and kappa) was observed in one cutaneous case. The accompanying infiltrate was mostly composed of T-lymphocytes admixed with variable numbers of monocytes/macrophages and eosinophils. Our results indicate that the histology of cutaneous specific manifestations of Hodgkin's disease correlates with that of the nodal counterpart in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Hodgkin Disease; Humans; Immunoenzyme Techniques; Immunophenotyping; Lewis X Antigen; Lymph Nodes; Proliferating Cell Nuclear Antigen; Reed-Sternberg Cells; Skin Neoplasms

To assess the effect of microwave heating on immunohistochemical staining of CD15 and CD30 antigens in Hodgkin's disease tissue samples.. Formalin fixed, paraffin wax embedded sections from 20 cases of Hodgkin's disease (six mixed cellularity, 14 nodular sclerosis) were immunostained for CD15, using two antibodies (DAKO-M1 and Leu-M1) and for CD30 using the antibody Ber-H2. The staining was carried out by conventional techniques which included pretreatment of sections with trypsin and on untreated sections following heating with microwaves. With antibody Leu-M1 an additional method, using a specific antimouse IgM bridge both with and without microwave heating, was also included. The results for each method were compared by counting positively stained Reed-Sternberg cells and estimating the staining intensity.. Microwave heating resulted in a substantial increase in the number of cells stained with antibodies to CD15 and also in the staining intensity. The best results were obtained using Leu-M1 with specific rabbit anti-mouse IgM bridge and microwave heating. Dramatic enhancement of the staining of Reed-Sternberg cells for CD30 was achieved following microwave heating, together with disappearance of the non-specific staining of plasma cells.. Microwave heating is strongly recommended for the immunohistochemical staining of CD15 and CD30 expressed by Reed-Sternberg cells in Hodgkin's disease.

Topics: Antigens, CD; Antigens, Differentiation, Myelomonocytic; Antigens, Neoplasm; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Microwaves; Paraffin Embedding; Reed-Sternberg Cells

The utility of staining for Leu M1 (CD15) as a diagnostic aid in Hodgkin's disease has been questioned because of a relative lack of specificity and sensitivity. Furthermore, interpretation is often made difficult by staining that tends to be weak and focal. Because the murine monoclonal anti-Leu M1 antibody is of immunoglobulin M type, it is reasonable to wonder whether improved immunohistochemical staining might result from use of a secondary goat antibody specific for the mouse mu heavy chain instead of the traditional one against mouse immunoglobulin. The two methods were compared, using a biotin-avidin detection system, on paraffin sections from 15 cases of Hodgkin's disease: 9 nodular sclerosing, 1 mixed cellularity, and 5 of nodular lymphocytic and histiocytic (L&H) type. In the nodular sclerosing/mixed cellularity group, the mu-specific detection method resulted in a greater number of cases with reactive Hodgkin's cells (7 versus 5), stained an average of more than three times as many neoplastic cells in each case (49% versus 14%), and usually produced staining that was distinctly more intense, often in a membrane and paranuclear distribution characteristic of Leu M1 in Hodgkin's cells. In the noLeu M1 in Hodgkin's cells. In the nodular L&H group, 1 case showed weak, focal staining with the newer method. None of the L&H cases stained using the traditional technique. It is concluded that use of a second-stage antibody that is directed specifically against mu heavy chains results in an improvement in immunohistochemical staining for Leu M1 in paraffin sections, which is of practical significance.

Topics: Animals; Antibodies, Monoclonal; Antibody Specificity; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Goats; Hodgkin Disease; Humans; Immunoglobulin M; Immunohistochemistry; Lewis X Antigen; Mice

Both immunophenotypic overlaps between Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL), and evolution of one into the other have been reported. However, the underlying assumption that the antigenic expression of Reed-Sternberg (RS) cells is consistent in the same patient has not been evaluated. Such an evaluation was undertaken by immunophenotyping paraffin-embedded lymphoid tissue biopsies with HD from 56 patients in whom multiple specimens were obtained, either simultaneously from different sites or at different times. The panel of antibodies we used included: CD3 polyclonal antiserum, DAKO-M1 (CD15), L26 (CD20), BerH2 (CD30), MT1 (CD43), DAKO-LCA (CD45RB), UCHL1 (CD45R0), LN2 (CD74), and DAKO-EMA. The phenotype of RS cells was identical in simultaneous biopsies in only 11 of 39 patients (28%) and remained constant in consecutive biopsies in only 4 of 21 patients (19%). Major differences (relative to cell lineage specific antigens) were observed in 10 of 39 patients with simultaneous biopsies and in 10 of 21 patients over time; they mainly involved expression of T-cell antigens. Minor differences (relative to any other antigen) were observed in 22 of 39 patients with simultaneous biopsies and in 15 of 21 patients over time; these mainly involved CD15 or CD74. This striking variability of the immunophenotype of RS cells in the same patient may be due to aberrant marker expression, as a result of the neoplastic state, and/or to modulation of antigenic expression in relation to the host environment. This inconsistency suggests caution when interpreting the relationship between HD and NHL by paraffin immunophenotyping alone.

Topics: Antibodies; Antigens, CD; Antigens, Differentiation, B-Lymphocyte; Biomarkers; Biopsy; Histocompatibility Antigens Class II; Histological Techniques; Hodgkin Disease; Humans; Immunophenotyping; Lewis X Antigen; Lymphoid Tissue; Lymphoma, Non-Hodgkin; Paraffin; Reed-Sternberg Cells

Thirty-three cases of Hodgkin's disease (thirteen nodular sclerosis, four diffuse, lymphocyte predominance, and sixteen mixed cellularity) were studied with Bauhinia purpurea (BPA), peanut agglutinin (PNA), anti-Leu-M1, LN2, and Ber-H2 by the avidinbiotin-peroxidase complex (ABC) method in paraffin sections. Reed-Sternberg (RS) cells and variants were stained positively with one or more of the reagents in all cases. BPA staining was positive in 32 of 33 cases (97.0%), PNA staining was positive in 23 of 33 cases (69.7%), Leu-M1 was positive in 13 of 33 cases (39.4%), LN2 was positive in 14 of 33 cases (42.4%), and Ber-H2 was positive in 24 of 33 cases (72.7%). Many RS cells were stained moderately to strongly and were readily recognized in 31 cases (96.9%) of BPA+, 10 (43.5%) of PNA+, 8 (61.5%) of Leu-M1+, 6 (42.9%) of LN2+, and 22 (91.7%) of Ber-H2+ cases; in the remaining positive cases, the RS cells were found only after careful searching. Three staining patterns were recognized: paranuclear, diffuse cytoplasmic, and membranous. These three patterns were obtained with all markers except for LN2. LN2 showed diffuse cytoplasmic staining in most of the positive cells, and a few cells showed paranuclear deposits. BPA reactivity was not affected by formalin fixation or paraffin embedding. Except for RS cells, BPA also showed dense cytoplasmic staining reaction with macrophage-histiocytes. Sixty cases of non-Hodgkin's diffuse lymphomas (30 T- and 30 B-cell origin) were also studied. Tumor cells were not stained with BPA, PNA, and Leu-M1, but stained positively with LN2 in six T-cell lymphomas and thirteen B-cell lymphomas, and with Ber-H2 in six T-cell lymphomas and one B-cell lymphoma. In conclusion, to facilitate the detection of RS cells and related variants in paraffin sections, BPA can be accepted as a useful marker due to its high-detection rate, reproducible staining pattern, and resistance to fixatives.

Topics: Antigens, CD; Antigens, Differentiation, B-Lymphocyte; Antigens, Neoplasm; Biomarkers; Biopsy; Histocompatibility Antigens Class II; Histological Techniques; Hodgkin Disease; Humans; Ki-1 Antigen; Lectins; Lewis X Antigen; Paraffin; Peanut Agglutinin; Plant Lectins; Reed-Sternberg Cells

We report the immunohistochemical and clinical features of two cases of morphologically typical anaplastic large-cell lymphoma. One patient had lymph node and focal visceral involvement, and the other patient had multiple-organ involvement by lymphoma. In both cases, the lymphoma cells were CD30 (Ber-H2) and CD15 (Leu-M1) positive and CD45 (common leukocyte antigen) negative--a phenotype that is commonly seen in Hodgkin's disease. This unusual phenotype in large-cell anaplastic lymphoma led to an initial misinterpretation in one of the cases. Large-cell anaplastic lymphomas are highly variable, both in immunophenotype and clinical presentation. Because of this variability, a broad immunophenotypic panel, in conjunction with morphological features, should be used to establish the correct diagnosis.

Topics: Adult; Antigens, CD; Antigens, Neoplasm; Diagnosis, Differential; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymph Nodes; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged

Immunohistochemistry is a valuable adjunct to the identification of Hodgkin's disease (HD) Reed-Sternberg (RS) cells, and in the differential diagnosis between HD, non-Hodgkin's lymphomas, and nonlymphoid neoplasms containing RS-like cells. The characteristic phenotype of RS cells in different subtypes of HD is described, with an emphasis on routine immunohistochemical stains. Some of the conflicting literature on this subject is reviewed to highlight pitfalls and controversies in the field.

Topics: Antigens, CD; Antigens, Neoplasm; Diagnosis, Differential; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymphoma, Non-Hodgkin; Reed-Sternberg Cells

Composite lymphomas have rarely been reported in Hodgkin's disease (HD), except in the lymphocyte predominance sub-type, and immunohistochemical investigations have been performed in only few cases. We describe the histological and immunophenotypical findings in a case of composite nodular sclerosing HD and high-grade, large cell non-Hodgkin's lymphoma (NHL). In our case HD and NHL cells displayed striking morphological and immunophenotypical divergence, suggesting a lack of correlation between the two neoplasms.

Topics: Adult; Antigens, CD; Antigens, CD20; Antigens, Differentiation, B-Lymphocyte; Antineoplastic Agents; beta-D-Galactoside alpha 2-6-Sialyltransferase; Histocompatibility Antigens Class II; HLA-DR Antigens; Hodgkin Disease; Humans; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Male; Membrane Glycoproteins; Mucin-1; Neoplasms, Multiple Primary; Phenotype; Sialyltransferases

The pathogenesis of Reed-Sternberg cells and variants (RS-H cells) found in rare cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is unknown. We studied 13 such cases by immunohistochemistry and in situ hybridization for identification of Epstein-Barr virus (EBV) RNA. The RS-H cells in five cases expressed the B-lineage marker CD20 and were negative for CD15. In two cases, the RS-H cells showed expression of both CD20 and CD15, whereas in another six cases, the cells were positive for CD15 but negative for CD20. Three of the cases expressing CD15 showed subsequent evidence of disseminated Hodgkin's disease. Regardless of the phenotype or clinical behavior, the RS-H cells in 12 of 13 cases were found to contain EBV RNA by in situ hybridization, but the surrounding neoplastic lymphocytes were invariably negative for EBV RNA. It is suggested that EBV has an important role in the pathogenesis of the RS-H cells in these rare cases.

Topics: Adult; Aged; Aged, 80 and over; Antigens, CD; Antigens, CD20; Antigens, Differentiation, B-Lymphocyte; Cell Transformation, Neoplastic; DNA, Viral; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; Leukemia, Lymphocytic, Chronic, B-Cell; Lewis X Antigen; Male; Middle Aged; Nucleic Acid Hybridization; Phenotype; Reed-Sternberg Cells; RNA, Viral

The association of chronic lymphocytic leukemia (CLL) and Hodgkin's disease has been controversial. Pleomorphic lymphoreticular cells resembling Reed-Sternberg cells have been observed in Richter's syndrome. Although most observers have favored the view that these cells are a component of a pleomorphic non-Hodgkin's lymphoma, some cases of histologically typical Hodgkin's disease have been described. We have studied two cases that appear to represent composite CLL and Hodgkin's disease, providing evidence for an interrelationship of these two disorders. Classic Reed-Sternberg cells and variants (RS-H) were seen in a background that was otherwise typical of CLL. Both patients initially presented with characteristic findings of CLL in the peripheral blood and bone marrow. The first patient was found to have RS-H cells within lymph nodes at initial presentation, and ultimately progressed to develop a disseminated lymphoma characteristic of Hodgkin's disease. In the second patient, RS-H cells were not discovered until 5 years later. Immunophenotypic studies confirmed these morphologic impressions. The predominant lymphocyte population had a phenotype consistent with B-cell CLL. By contrast, the RS-H cells were strongly positive for CD15 (Leu M1) with staining of the Golgi region and cell membrane. Additionally, the RS-H cells were surrounded by rosettes of lymphocytes that marked as T cells. In both of the patients, a small percentage of RS-H cells expressed positivity for the B-cell marker L-26, which may indicate an origin from the underlying CLL. These findings support a B-cell origin for the malignant cell in some cases of Hodgkin's disease and suggest that Hodgkin's disease in some patients may be related to or derived from a coexisting lymphoid malignancy.

Topics: Antigens, Differentiation; B-Lymphocytes; Biopsy; Cell Membrane; Golgi Apparatus; Hodgkin Disease; Humans; Immunoglobulin G; Immunoglobulin M; Immunohistochemistry; Immunophenotyping; Leukemia, Lymphocytic, Chronic, B-Cell; Lewis X Antigen; Lymph Nodes; Male; Middle Aged

Three cases are reported in which an initial diagnosis of the plasma cell variant of Castleman's disease was made, but in which a second lymph node biopsy within a year showed evidence of Hodgkin's disease. Review of the initial biopsy indicated that atypical CD15 and CD30 positive cells were present in the initial biopsy. This illustrates the difficulty in making the diagnosis of Castleman's disease and suggests that the lymphoid reaction to the presence of Hodgkin's disease may result in similar histological appearances. The need for re-evaluation of the diagnosis of Castleman's disease in the face of persistent or recurrent disease is stressed.

Topics: Adolescent; Adult; Antigens, CD; Antigens, Neoplasm; Biopsy; Castleman Disease; Diagnosis, Differential; Hodgkin Disease; Humans; Immunoenzyme Techniques; Ki-1 Antigen; Lewis X Antigen; Male

The gene encoding p53 phosphoprotein, originally believed to be an oncogene, recently has been proposed as a candidate antioncogene (tumor-suppressor gene). Abnormalities of the p53 gene expression have been demonstrated in different human malignancies including carcinomas and sarcomas, but little information concerning p53 immunoreactivity in human lymphomas is so far available. In this study immunohistochemical staining for p53-protein was performed on frozen- and paraffin-embedded samples from patients with Hodgkin's (HD) and non-Hodgkin's lymphomas (NHL). No p53 immunoreactivity could be demonstrated in any cell type in nonneoplastic lymphoid samples, including germinal center cells in reactive lymph nodes and cortical thymocytes. On the other hand, a significant proportion of p53+ neoplastic cells was observed in 23 of 31 cases of HD and 17 of 68 cases of NHL. All positive lymphoma cases were diagnosed as high-grade or CD30+ anaplastic NHL. The demonstration of abnormal expression of p53 protein in these diseases can contribute to addressing unresolved issues regarding the origin and pathogenesis of HD and CD30+ anaplastic lymphomas.

Topics: Antibodies, Monoclonal; Antigens, CD; Antigens, Neoplasm; Gene Expression Regulation, Neoplastic; Genes, p53; Hodgkin Disease; Humans; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphoma, Non-Hodgkin; Neoplasm Proteins; Thymus Gland; Tumor Suppressor Protein p53

Using a monoclonal antibody specific to the Lewis X antigen (anti-Lex), the authors studied 103 cases of Hodgkin's disease (HD) in comparison with 57 cases of non-Hodgkin's lymphoma (NHL); three cases of granulocytic sarcoma (GS); two cases of malignant histiocytosis (MH); one case of monoblastic leukemia (ML); one case of interdigitating reticulum cell sarcoma (IRCS); six cases of histiocytosis X (HX); one case of reticulohistiocytoma (RH); 44 various reactive conditions of the lymph node (LN). Reed-Sternberg and related (R-S) cells stained selectively in 80 of 92 cases of HD (87.0%), excluding 11 cases of lymphocyte predominance type. The stain was better in B-5-fixed specimens than in formalin-fixed specimens, showing a dense deposit of reaction products at a paranuclear site and on the cell surface. The staining results were compared with those of Leu-M1 and found to be superior both qualitatively and quantitatively (detection rate of R-S cells: 87.0% versus 68.5% of Leu-M1). Granulocytes, rare epithelioid histiocytes, and some endothelial and/or erythrocytes also stained with anti-Lex. The stain had positive results in three cases of GS showing a diffuse cytoplasmic staining pattern. Of NHL, two of 29 peripheral T-cell lymphomas stained to show rare paranuclear deposits without cell surface staining. The stain had negative results in MH, ML, IRCS, HX, and RH. Of 45 reactive LN, minute subcapsular collections of Lewis X+, altered-appearing Langerhans'-like cells, were observed in all ten LN from human immunodeficiency virus (HIV)-associated persistent generalized lymphadenopathy (PGL). The stain had negative results in all other various reactive conditions of LN. In conclusion, Lewis X staining is useful as a marker for R-S cells in paraffin sections with staining results superior to those of Leu-M1. Lewis X staining also detects subcapsular clustering of altered-appearing Langerhans'-like cells in PGL, which has not been described previously and warrants additional study.

Topics: Acquired Immunodeficiency Syndrome; Antibodies, Monoclonal; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Diagnosis, Differential; Histiocytic Sarcoma; Histiocytosis, Langerhans-Cell; Hodgkin Disease; Humans; Leukemia, Myeloid; Lewis X Antigen; Lymph Nodes; Lymphoma, Non-Hodgkin; Male; Middle Aged; Staining and Labeling

In this report we analyze the morphological and immunohistochemical findings observed in 5 cases of CD30/Ki-1 positive anaplastic large cell lymphoma, a recently recognized neoplastic entity. In comparison with the Ki-1 lymphomas so far described, these cases showed a fairly large number of Reed-Sternberg-like cells, often admixed with small lymphocytes and occasional eosinophils. Moreover, in all our cases immunohistochemical reactions detected the CD15/Leu-M1 antigen, together with markers of the T-lineage and of lymphoid activation. In previous studies the CD15/Leu-M1 antigen has been found in the majority of cases of Hodgkin's disease, but has been stated to be absent typically in Ki-1 lymphomas. Our results indicate that this antigen cannot be considered a reliable tool to distinguish between Ki-1 lymphomas and Hodgkin's disease. Furthermore, the morphological and immunohistochemical findings reported suggest that in some cases Ki-1 cell lymphoma and Hodgkin's disease may be closely related. They may represent different steps in the progression of the same lymphoproliferative disorder.

Topics: Adult; Antigens, CD; Antigens, Differentiation; Female; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Lymph Nodes; Lymphoma; Male; Middle Aged

The authors examined cytomegalovirus (CMV)-infected tissues and Hodgkin's Disease (HD) cases with immunohistochemical assays for Leu-M1 and CMV. The cytologic characteristics were correlated with immunostaining patterns. Cytomegalovirus-infected cells in lymph node, lung, and esophagus sections showed Cowdry type A inclusions, and many had granular cytoplasmic inclusions. All infected cells showed nuclear staining with an anti-CMV antibody. Leu-M1 reacted with CMV-infected cells in cytoplasmic areas, particularly near the nucleus simulating the characteristic staining pattern of Reed-Sternberg (R-S) cells. Cytoplasmic staining intensified as the intranuclear inclusions increased in size. Reed-Sternberg cells showed characteristic Leu-M1 positivity along the cell membrane and golgi zone. At times, Leu-M1 staining of CMV-infected cells was indistinguishable from that of R-S cells. None of the R-S cells reacted with the antibody to CMV. Recognition of the reactivity of Leu-M1 with CMV-infected cells is important in avoiding misdiagnosis of CMV lymphadenitis as HD.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Cytomegalovirus Infections; Diagnostic Errors; Female; Hodgkin Disease; Humans; Immunoenzyme Techniques; Lewis X Antigen; Male; Middle Aged

The purpose of this report is to assess whether phenotyping by three monoclonal antibodies routinely used in paraffin sections (Ber-H2-Leu-M1-EMA) and shown to be the most useful for diagnosis may be a predictive factor for recurrences. Among 563 patients diagnosed as having Hodgkin's disease (24% of whom had recurrence), we selected 153 patients with and without recurrence, with matching clinical stage. For all of these cases, histologic material was tested by immunostainings with satisfactory control samples. No phenotype was specific for Hodgkin's disease, although the phenotype Ber-H2-Leu-M1-EMA was predominant. No phenotype was found to be a predictive factor for recurrences, and none was unchanged during the clinical course, except when recurrence occurred as non-Hodgkin's lymphoma.

Topics: Antigens, CD; Antigens, Differentiation; Antigens, Differentiation, Myelomonocytic; Antigens, Neoplasm; Biomarkers, Tumor; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Membrane Glycoproteins; Mucin-1; Neoplasm Recurrence, Local; Phenotype; Prognosis

Monoclonal antibody to LeuM1, a granulocyte-related differentiation antigen, represents a highly effective reagent for detection of diagnostic "Reed-Sternberg" cells and variants in paraffin-embedded tissues of Hodgkin's disease. The "Reed Sternberg" cell in all the cases of Hodgkin's disease except lymphocyte predominance variety revealed positive intracytoplasmic/paranuclear granular staining with LeuM1 marker. The R-S cells in lymphocyte predominance variety contain probably sialylated LeuM1 antigen. All the cases of non-Hodgkin's lymphoma and reactive lymphadenitis showed no staining with LeuM1 monoclonal antibody. Therefore this antibody represents a potentially helpful diagnostic discriminant in the assessment of Hodgkin's disease and its distinction from non-Hodgkin's lymphomas and morphologically similar reactive lymphoid lesions.

Topics: Antibodies, Monoclonal; Antibodies, Neoplasm; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Child; Diagnosis, Differential; Hodgkin Disease; Humans; Lewis X Antigen; Lymphoma, Non-Hodgkin; Male

Hodgkin's disease (HD) is sometimes difficult to distinguish from non-Hodgkin's lymphomas, and a reliable marker for Reed-Sternberg and related (R-S) cells in paraffin sections would be useful. Ninety-one cases of HD with PNA, anti-Leu M1, and LN-2, and 90 cases with Ber-H2 were studied. The staining results were evaluated independently. R-S cells stained positively with one or more of the reagents in all cases. PNA staining was positive in 78 cases (85.7%); Leu M1, 63 (69.2%); LN-2, 71 (78.0%); and Ber-H2, 80 cases (88.9%). Positively stained cells were readily recognized in 71 cases (91.0%) of PNA+, 51 (80.9%) of Leu M1+, and 51 (71.8%) of LN-2+ and 71 (88.7%) of Ber-H2+ cases; the cells were found only after careful search in the remaining cases. Sixteen cases of peripheral T-cell lymphoma (large cell type, ten; mixed, five; unclassifiable, one) were also stained. Tumor cells did not stain with PNA or anti-Leu M1 in any of the 16 cases but did stain positively with LN-2 in four and with Ber-H2 in five. Thus, the detection rate of R-S cells was the highest with Ber-H2, closely followed by PNA. PNA, however, stained the largest number of R-S cells per case, and the results were least affected by the type of fixative employed. Staining of peripheral T-cell lymphoma appeared to be nil or extremely rare with PNA and Leu M1, whereas it was not uncommon with Ber-H2 and LN-2. In conclusion, to facilitate the detection of R-S cells in paraffin sections, the application of a panel of three markers, PNA, Leu M1, and Ber-H2, appears to be necessary at this point in time.

Topics: Antigens, Differentiation; Antigens, Differentiation, B-Lymphocyte; Antigens, Differentiation, Myelomonocytic; Antigens, Neoplasm; Cytological Techniques; Diagnosis, Differential; Histiocytes; Histocompatibility Antigens Class II; Hodgkin Disease; Humans; Ki-1 Antigen; Lectins; Lewis X Antigen; Lymphoma, Non-Hodgkin; Paraffin; Peanut Agglutinin

The authors analyzed 50 cases of Hodgkin's disease (HD) with a panel of antibodies which detect B-cell and T-cell specific markers and activation antigens using a sensitive immunocytochemical technique and paraformaldehyde-lysine-periodate (PLP) fixed-frozen tissues. In 60% of cases either T-cell or B-cell specific antigens were detected on Reed-Sternberg (RS) cells. Most T-cell cases were of nodular sclerosing (NS) and mixed cellularity (MC) type (65% and 30%, respectively) and most B-cell cases were either of NS or lymphocyte predominant (LP) type (55% and 45%, respectively). Leukocyte common antigen (LCA) was usually negative on RS cells in NS, but was present in approximately 50% of the cases of MC and LP types. Almost all cases were positive for the CD30 antigen (Ki-1). Most cases were also positive for CD15 (LeuM1) with the exception of the LP type. Activation antigens (Ia, CD25, T9) were expressed in a high proportion of cases regardless of subtype. The results suggest that most cases of HD are histogenetically derived from activated T-cells or B-cells.

Topics: Adolescent; Adult; Aged; Antigens, Differentiation; Antigens, Differentiation, Myelomonocytic; Antigens, Neoplasm; Child; Female; Frozen Sections; Histiocytes; Histocompatibility Antigens; Histocompatibility Antigens Class II; Hodgkin Disease; Humans; Immunoenzyme Techniques; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Male; Middle Aged; Receptors, Interleukin-2

Topics: Antigens, Differentiation, Myelomonocytic; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Lymphoma, Follicular; Phenotype

The feasibility of comparative quality assessment studies in immunocytochemistry was examined. The reactions of three CD15 antibodies--anti-Leu M1, DM1, and Tü9--were examined in paraffin wax sections in Hodgkin's disease under a variety of different fixation and pre-treatment conditions, using four immunochemical detection techniques. All three antibodies stained Reed-Sternberg cells, but DM1 could be used at slightly higher dilutions to achieve comparable results. Tissue fixed in formol sublimate showed the most intense staining reactions, and formol saline and neutral buffered formalin gave relatively poor results. Although neuraminidase pre-treatment improved staining, its routine use is probably contraindicated by its high cost. Trypsinisation has some value for sections of tissue fixed in formol saline and neutral buffered formalin. The avidin-biotin complex technique produced the best results, but indirect immunoperoxidase produced acceptable results, is technically easier to perform, and is less expensive. It is concluded that information regarding variations in techniques and commercially available reagents, which may be of use in routine diagnostic histopathology, can be obtained by comparative quality assessment studies of this type.

Topics: Adult; Antigens, CD; Antigens, Differentiation; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Female; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Male; Middle Aged; Quality Control

A retrospective analysis of 117 cases of Hodgkin's disease treated at the Centre G.F. Leclerc between 1976 and 1985 was performed with three objectives: 1): to re-evaluate the histologic subtype by the Lukes-Rye classification according to recent data; 2): to demonstrate the frequency of CD 15 antigen by an indirect, three stage immunoperoxidase technique on initial node biopsy histologic sections; 3): to study the prognostic value of this antigen. Histologic reclassification disclosed that 9 cases were in fact non Hodgkin's lymphoma. The remaining 108 cases were classified as lymphocyte predominant (n = 11), nodular sclerosis (n = 77), and mixed cellularity (n = 17), with no cases of either lymphocyte depletion or nodular paragranuloma of Poppema and Lennert identified. In these specimens, fixed in Bouin's solution and embedded in paraffin, CD 15 antigen was detected in the Reed-Sternberg cells and the mononuclear variety of Hodgkin cells in 64 patients (59%). The presence of this antigen was independent of histologic subtype, patient age or sex, clinical stage and the presence of systemic symptoms. Both actuarial disease-free and overall survivals showed that the prognosis of Hodgkin's disease is more favorable in CD 15 positive cases.

Topics: Antigens, Differentiation; Female; Hodgkin Disease; Humans; Immunohistochemistry; Lewis X Antigen; Male; Prognosis

A series of 50 specimens of Hodgkin's disease and 10 of reactive follicular hyperplasia were examined by means of indirect immunoperoxidase staining with a monoclonal antibody AGF 4.48: this is known to bind to 3-fucosyl-N-acetyllactosamine, which, in particular, is expressed by granulocyte series cells. Most Reed-Sternberg and many Hodgkin's cells were labelled by the antibody after pretreatment with neuraminidase. Routinely processed paraffin wax embedded sections proved suitable for staining. The findings were comparable with those reported by others with monoclonal antibodies to various other granulocyte markers. This technique is of potential diagnostic value.

Topics: Antibodies, Monoclonal; Histiocytes; Hodgkin Disease; Humans; Immunoenzyme Techniques; Lewis X Antigen; Lymph Nodes; Lymphoma