Large B‐cell lymphoma rich in T‐cells and simulating Hodgkin's disease
- 1 September 1991
- journal article
- Published by Wiley in Histopathology
- Vol. 19 (3), 211-220
- https://doi.org/10.1111/j.1365-2559.1991.tb00024.x
Abstract
Unusual clinicopathological features drew our attention to nine of 208 cases diagnosed as Hodgkin's disease. Lymph node biopsy specimens in these cases were immunostained with monoclonal antibodies against B-cell, T-cell and Reed-Sternberg cell associated antigens and epithelial membrane antigen (EMA). Reed–Sternberg-like and other atypical large cells were dispersed in a diffuse, small lymphocyte-rich background, consistent more often with the initial diagnosis of diffuse, lymphocyte predominance Hodgkin's disease. The clinical stage in these cases was unusually advanced (stages III and IV). Splenomegaly was a common feature (six of nine cases), the male to female ratio was 7:2 and the median age was 55 years (range 25–77). Response to recognized regimes for Hodgkin's disease treatment was poor in most cases, and three patients died early of their disease. Large cells were B-lymphocytes expressing EMA—an immunophenotype similar to nodular, lymphocyte predominance Hodgkin's disease. Reed–Sternberg cell and T-cell associated antigens were absent on large cells. Mature T-cells, with nuclear irregularities in some instances, predominated in the background. A more appropriate diagnostic category is, therefore, T-cell-rich B-cell lymphoma. The cases represent a 4–5% erroneous diagnosis of Hodgkin's disease and further suggest that there is a need for revision of criteria for the diagnosis of the diffuse, lymphocyte predominance variant.Keywords
This publication has 36 references indexed in Scilit:
- Immunohistochemical demonstration of leucocyte differentiation antigens on paraffin sections using a modified AMeX (ModAMeX) methodHistopathology, 1989
- Leucocyte common antigen in the differential diagnosis of Hodgkin's diseaseHematological Oncology, 1989
- The Elusive Reed–Sternberg CellNew England Journal of Medicine, 1989
- Nodular and Diffuse Types of Lymphocyte Predominance Hodgkin's DiseaseNew England Journal of Medicine, 1988
- Hodgkin's diseaseHistopathology, 1987
- Use of Leu M1 and antiepithelial membrane antigen monoclonal antibodies for diagnosing Hodgkin's disease.Journal of Clinical Pathology, 1986
- HUMAN LYMPHOID CELLS EXPRESS EPITHELIAL MEMBRANE ANTIGENThe Lancet, 1984
- Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP complexes).Journal of Histochemistry & Cytochemistry, 1984
- Diagnosis of Human Lymphoma with Monoclonal Antileukocyte AntibodiesNew England Journal of Medicine, 1983
- Hodgkin and sternberg‐reed cells contain antigens specific to late cells of granulopoiesisInternational Journal of Cancer, 1982