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A novel immunohistochemical classifier to distinguish Hodgkin lymphoma from ALK anaplastic large cell lymphoma.
[hodgkin lymphoma, classical]
Classical
Hodgkin
lymphoma
and
ALK
(
-
)
anaplastic
large
cell
lymphoma
share
many
features
like
strong
CD
30
expression
and
usually
loss
of
B-
and
T
-
cell
markers
.
However
,
their
clinical
course
is
dramatically
different
with
curability
rates
of
>
90
%
for
classical
Hodgkin
lymphoma
and
an
unfavorable
prognosis
for
anaplastic
large
cell
lymphoma
.
Classical
Hodgkin
lymphoma
and
ALK
(
-
)
anaplastic
large
cell
lymphoma
can
usually
be
distinguished
by
PAX
5
expression
in
the
Hodgkin
and
Reed
-
Sternberg
cells
of
classical
Hodgkin
lymphoma
and
expression
of
cytotoxic
molecules
in
tumor
cells
of
anaplastic
large
cell
lymphoma
.
However
,
in
some
cases
the
differential
diagnosis
is
difficult
owing
to
absence
of
established
markers
.
To
be
able
to
better
classify
these
cases
,
we
reevaluated
gene
expression
data
of
microdissected
tumor
cells
of
both
lymphomas
for
differentially
expressed
genes
.
A
classifier
was
established
,
comprising
four
genes
strongly
expressed
in
Hodgkin
and
Reed
-
Sternberg
cells
of
classical
Hodgkin
lymphoma
(
MDC
/
CCL
22
,
CD
83
,
STAT
3
,
and
TUBB
2
B
)
.
Applying
this
classifier
to
a
test
cohort
,
Hodgkin
lymphoma
was
successfully
distinguished
from
ALK
(
-
)
anaplastic
large
cell
lymphoma
with
an
accuracy
of
97
%
(
43
/
44
)
.
MDC
/
CCL
22
,
CD
83
,
and
STAT
3
have
also
been
found
to
be
expressed
in
antigen-presenting
cells
.
Therefore
,
based
on
our
established
classifier
,
Hodgkin
and
Reed
-
Sternberg
cells
differ
from
tumor
cells
of
anaplastic
large
cell
lymphoma
,
which
can
successfully
be
applied
for
practical
purposes
in
histopathologic
diagnostics
.
Diseases
Validation
Diseases presenting
"loss of b- and t-cell markers"
symptom
hodgkin lymphoma, classical
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