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Pediatric Hodgkin Lymphoma in a South Indian Regional Cancer Center: Its Immunomorphology, Tumor-Associated Macrophages, and Association with Epstein-Barr Virus.
[hodgkin lymphoma, classical]
Pediatric
Hodgkin
lymphoma
(
HL
)
comprises
approximately
a
fifth
of
all
patients
with
HL
in
India
.
Seventy
-
four
cases
of
pediatric
classical
Hodgkin
Lymphoma
(
cHL
)
from
a
regional
cancer
center
in
southern
India
were
analyzed
on
a
tissue
microarray
(
TMA
)
for
the
stage
of
B-
cell
differentiation
of
the
Hodgkin
/
Reed
Sternberg
(
HRS
)
cell
by
immunohistochemistry
(
IHC
)
using
CD
10
,
bcl
6
,
MUM
1
/
IRF
4
,
and
CD
138
.
Fifty
-
two
of
seventy-
four
(
70
.
3
%
)
cases
were
of
late
germinal
center
/
early
post-germinal
center
phenotype
(
CD
10
-
/
bcl
6
-
/
MUM
1
+
/
CD
138
-
)
.
Epstein-
Barr
virus
(
EBV
)
association
using
Epstein-
Barr
virus
encoded
RNA
(
EBER
)
RISH
and
EBV-LMP
1
immunohistochemistry
(
IHC
)
revealed
an
EBV
association
of
93
%
.
Tumor
-associated
macrophages
(
TAM
)
in
the
microenvironment
were
also
assessed
on
the
TMA
by
CD
68
IHC
,
and
most
cases
(
59
.
7
%
)
showed
>
25
%
TAMs
,
with
no
case
showing
≤
5
%
.
These
findings
indicate
that
pediatric
cHL
in
India
is
a
tumor
,
predominantly
,
of
late
germinal
center
/
early
post-germinal
center
B
cells
,
is
almost
invariably
EBV
associated
,
and
with
a
high
number
of
TAMs
in
the
microenvironment
.
This
latter
finding
suggests
that
criteria
other
than
TAM
scores
need
to
be
developed
for
risk
stratification
of
pediatric
EBV-associated
HL
especially
in
developing
countries
.
Diseases
Validation
Diseases presenting
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated