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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
"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