lewis-x-antigen and Lymphoma--T-Cell

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

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

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

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

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