Department of Pathology, The University of Jordan, Queen Rania St, Amman 11942, Jordan.
Department of Pathology, The University of Jordan, Queen Rania St, Amman 11942, Jordan.
Ann Diagn Pathol. 2019 Jun;40:72-76. doi: 10.1016/j.anndiagpath.2019.04.009. Epub 2019 Apr 23.
Primary mediastinal large B-cell lymphoma (PMBL) and classic Hodgkin lymphoma (CHL) are the most common large cell lymphomas arising in the mediastinum and are thought to be closely related histogenetically. Although the distinction between PMBL and CHL is usually straightforward, in some cases it is challenging and rarely these neoplasms have intermediate features and qualify for the diagnosis of mediastinal gray zone lymphoma (GZL). CD83 and fascin are markers of CHL and CD23 is a marker of PMBL. In this study we assess the utility of this combination of these immunohistochemical markers to distinguish CHL from PMBL. We retrospectively collected cases of PMBL, CHL and GZL from three centers. Tissue sections were stained with CD83, fascin and CD23. CD83 was expressed in the neoplastic cells of 100% of CHL (22/22), 93% of GZL (16/18) and 41% of PMBL (9/22). Similarly, fascin was positive in the neoplastic cells of 100% of CHL (22/22), 86% of GZL (18/21) and 32% of PMBL (7/22). CD23 was positive in 95% of PMBL (21/22), 67% of GZL (12/18) and 9% of CHL (2/22). CD83 and fascin are sensitive markers for CHL but not specific whereas CD23 is sensitive for PMBL and uncommon in CHL. The GZL cases in this study had an intermediate immunophenotype, but the results were closer to CHL than PMBL. A large panel of immunohistochemical studies is recommended to distinguish CHL from PMBL entities and we suggest that CD83, fascin and CD23 add value to panels designed for this differential diagnosis.
原发性纵隔大 B 细胞淋巴瘤（PMBL）和经典霍奇金淋巴瘤（CHL）是最常见的纵隔大细胞淋巴瘤，被认为在组织发生上密切相关。尽管 PMBL 和 CHL 之间的区别通常很明显，但在某些情况下具有挑战性，而且这些肿瘤很少具有中间特征，并符合纵隔灰色区淋巴瘤（GZL）的诊断。CD83 和 fascin 是 CHL 的标志物，CD23 是 PMBL 的标志物。在这项研究中，我们评估了这种免疫组织化学标志物组合在区分 CHL 和 PMBL 中的应用。我们从三个中心回顾性收集了 PMBL、CHL 和 GZL 病例。组织切片用 CD83、fascin 和 CD23 染色。CD83 在 100%的 CHL（22/22）、93%的 GZL（16/18）和 41%的 PMBL（9/22）的肿瘤细胞中表达。同样，fascin 在 100%的 CHL（22/22）、86%的 GZL（18/21）和 32%的 PMBL（7/22）的肿瘤细胞中阳性。CD23 在 95%的 PMBL（21/22）、67%的 GZL（12/18）和 9%的 CHL（2/22）中阳性。CD83 和 fascin 是 CHL 的敏感标志物，但不具有特异性，而 CD23 是 PMBL 的敏感标志物，在 CHL 中很少见。本研究中的 GZL 病例具有中间免疫表型，但结果更接近 CHL 而不是 PMBL。建议进行大量免疫组化研究，以区分 CHL 和 PMBL 实体，并建议 CD83、fascin 和 CD23 可用于设计用于这种鉴别诊断的免疫组化面板。
