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Variable Expression of B-cell Transcription Factors in Reactive Immunoblastic Proliferations: A Potential Mimic of Classical Hodgkin Lymphoma.
[hodgkin lymphoma, classical]
Reactive
immunoblastic
proliferations
can
histologically
mimic
classical
Hodgkin
lymphoma
(
CHL
)
,
and
show
diffuse
CD
30
expression
in
large
cells
.
The
lack
of
expression
of
CD
15
in
a
subset
of
CHL
further
complicates
their
separation
from
immunoblastic
proliferations
.
Loss
of
expression
of
B-
cell
transcription
factors
is
frequently
exploited
in
making
a
diagnosis
of
CHL
;
however
,
the
staining
patterns
of
B-
cell
transcription
factors
in
immunoblastic
proliferations
have
not
been
extensively
studied
.
Thirty
-
three
cases
of
reactive
immunoblastic
proliferations
were
evaluated
using
a
panel
of
immunohistochemistry
for
CD
30
,
CD
15
,
CD
2
0
,
CD
3
,
κ
,
λ
,
CD
4
5
RB
,
MUM
1
,
PAX
5
,
OCT
2
,
and
BOB
.
1
,
as
well
as
Epstein-
Barr
virus
(
EBV
)
/
EBV-encoded
ribonucleic
acid
in
situ
hybridization
.
A
newly
developed
dual-color
chromogenic
in
situ
hybridization
technology
for
detection
of
κ
/
λ
mRNAs
was
also
used
.
The
majority
of
immunoblasts
expressed
CD
30
in
14
of
33
(
42
%
)
cases
;
none
expressed
CD
15
.
Loss
or
weak
expression
of
at
least
1
transcription
factor
in
B
immunoblasts
,
most
commonly
PAX
5
,
was
noted
in
24
of
29
(
83
%
)
cases
.
A
polytypic
light
chain
expression
pattern
was
detected
by
immunohistochemistry
in
14
of
22
(
63
.
6
%
)
cases
and
by
dual-color
chromogenic
in
situ
hybridization
in
9
of
10
(
90
%
)
cases
studied
.
EBV-encoded
ribonucleic
acid
was
detected
in
8
of
33
(
24
.
2
%
)
cases
,
5
of
which
were
clinically
unrelated
to
infectious
mononucleosis
.
We
conclude
that
B-
cell
transcription
factors
can
show
loss
or
weak
expression
in
a
significant
proportion
of
reactive
immunoblastic
proliferations
,
and
,
therefore
,
staining
for
B-
cell
transcription
factors
together
with
CD
30
should
be
interpreted
with
caution
before
a
diagnosis
of
CHL
is
made
.
Diseases
Validation
Diseases presenting
"reactive immunoblastic proliferations"
symptom
hodgkin lymphoma, classical
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