Kohno Kei, Sakakibara Ayako, Iwakoshi Akari, Hasegawa Masaki, Adachi Shiro, Ishikawa Eri, Suzuki Yuka, Shimada Satoko, Nakaguro Masato, Shimoyama Yoshie, Takahara Taishi, Takahashi Emiko, Ohashi Akiko, Satou Akira, Kato Seiichi, Asano Naoko, Nakamura Shigeo
Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan.
Department of Pathology, National Hospital Organization Nagoya Medical Center, Aichi, Japan.
Pathol Int. 2020 Feb;70(2):108-115. doi: 10.1111/pin.12888. Epub 2020 Jan 2.
Although several reports have highlighted neoplastic PD-L1 (nPD-L1) expression in classic Hodgkin lymphoma (CHL), some have addressed associations between its expression and detailed histopathologic features. Here we describe four cases of syncytial variant of CHL (SV-CHL), with and without Epstein-Barr virus (EBV) association, and highlight the diagnostic utility of PD-L1 (clone SP142) immunohistochemistry. The patients were a 61-year-old male, 45-year-old male, 85-year-old female, and 89-year-old female. All presented with cervical or axillary lymphadenopathy, which on biopsy had the established histopathologic features of SV-CHL with a biphasic pattern of cohesive sheets of large tumor cells and typically scattered distribution of Hodgkin and Reed-Stenberg (HRS) cells. These tumor cells showed identical immunophenotypic findings for CD15, CD30, Fascin, PAX5, OCT2, BOB1 and EBV harboring, regardless of location. The exception was absent or decreased expression of nPD-L1 from tumor cells in the confluent sheets, contrasting with HRS cell positivity in typical areas of CHL. These findings offer the first suggestion of possible downregulation of nPD-L1 expression in association with the histopathologic progression of CHL. The results may be relevant for recognizing 'confluent' sheets in the diagnostic workup for SV-CHL.
尽管有几份报告强调了经典型霍奇金淋巴瘤（CHL）中肿瘤性PD-L1（nPD-L1）的表达，但一些报告探讨了其表达与详细组织病理学特征之间的关联。在此，我们描述了4例CHL合胞体变异型（SV-CHL）病例，有或无爱泼斯坦-巴尔病毒（EBV）关联，并强调了PD-L1（克隆号SP142）免疫组化的诊断效用。患者为1名61岁男性、1名45岁男性、1名85岁女性和1名89岁女性。所有患者均表现为颈部或腋窝淋巴结肿大，活检显示具有SV-CHL既定的组织病理学特征，呈大肿瘤细胞紧密成片的双相模式，霍奇金和里德-斯腾伯格（HRS）细胞通常呈散在分布。无论位置如何，这些肿瘤细胞在CD15、CD30、Fascin、PAX5、OCT2、BOB1和EBV携带方面显示出相同的免疫表型结果。例外情况是融合成片区域的肿瘤细胞中nPD-L1表达缺失或降低，这与CHL典型区域的HRS细胞阳性形成对比。这些发现首次提示nPD-L1表达可能与CHL的组织病理学进展相关而下调。这些结果可能与在SV-CHL诊断检查中识别“融合”成片有关。
