Comparative pathologic analysis of mediastinal B-cell lymphomas: selective expression of p63 but no GATA3 optimally differentiates primary mediastinal large B-cell lymphoma from classic Hodgkin lymphoma

Diagnostic Pathology

Ji Eun Kim¹  Hyekyung Lee²  Ji-Young Choe³  Soo Kee Min³  Suk Jin Choi⁴  Hyun-Jung Kim⁵  Hee Young Na⁶  Gyeongsin Park⁷  Hee Kyung Kim⁸  Hee Jeong Cha⁹ 

[1] Department of Pathology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine;Departments of Pathology, Eulji University Hospital;Departments of Pathology, Hallym University Sacred Heart Hospital;Departments of Pathology, Inha University Hospital;Departments of Pathology, Inje Univ. Sanggye Paik Hospital;Departments of Pathology, Seoul National University Bundang Hospital;Departments of Pathology, Seoul St. Mary’s Hospital, Catholic University of Korea;Departments of Pathology, Soonchunhyang Univ. Bucheon Soonchunhyang Hospital;Departments of Pathology, Ulsan University Hospital;

关键词: Primary mediastinal large B-cell lymphoma;    Classic Hodgkin lymphoma;    p63;    GATA3;    Cyclin E;    Immunohistochemistry;   

DOI  :  10.1186/s13000-019-0918-x

来源: DOAJ

【 摘 要 】

Abstract Background Interpretation of mediastinal biopsy is often challenging even for experienced pathologists especially when a hematolymphoid neoplasm is suspected. Primary mediastinal large B-cell lymphoma (PMLBCL) and classic Hodgkin lymphoma (CHL) represent two major types of mature B-cell lymphomas of the mediastinum. Although PMLBCL and mediastinal CHL share many clinicopathologic characteristics, their treatment strategies and responses are remarkably different. We therefore aimed to find distinctive histologic or protein markers to better differentiate these two lesions. Methods Search for primary mediastinal B-cell lymphomas found 52 consecutive cases from 3 university hospitals of Korea during 2005 to 2012. Among them, 32 cases that were available for additional immunohistochemistry (IHC) assessment were enrolled in this study. These cases consisted of the following: CHL (N = 13), PMLBCL (N = 16), and B-cell lymphoma unclassifiable, with features intermediate between diffuse large B-cell lymphoma and CHL (gray zone lymphoma, N = 3). Along with the clinicopathologic findings, the expression of p63, GATA3 and cyclin E was investigated by IHC in the three categorized lesions mentioned above. Results Most clinical features overlapped between PMLBCL and CHL except for the increased disease progression and mortality found in PMLBCL. In the pathologic review, the presence of epithelioid granuloma favored a diagnosis of CHL, whereas reticulated or alveolar patterns of fibrosis were characteristic of PMLBCL. For protein markers, p63 was predominantly positive in PMLBCL (15/16) compared with CHL (2/13), which indicates that p63 is a marker of the highest diagnostic accuracy when calculated by the area under the ROC curve. GATA3 was expressed in the majority of CHL cases (10/13) compared with PMLBCL (0/16), while the expression of cyclin E was only rarely present in a minor population of PMLBCL. Conclusions P63 expression in tumor cells, even focal expression, and no GATA3 is the most helpful feature in distinguishing PMLBCL from mediastinal CHL.

【 授权许可】

Unknown