The immunophenotype of splenic lymphoma with villous lymphocytes and its relevance to the differential diagnosis with other B-cell disorders

The aim of this study was to elucidate the origin of Hodgkin's and Reed-Sternberg cells. Lymph node cytospins and frozen sections from 20 cases of Hodgkin's disease of different histological subtypes were immunostained by the immunoalkaline phosphatase technique using a panel of monoclonal antibodies. As expected, the Hodgkin's and Reed-Sternberg cells of all cases were positive for the CD30 (Ki-1), CD 15 (hapten X) and CD25 (Tac) antigens. In eight cases, a variable percentage of typical Hodgkin's and Reed-Sternberg cells showed a clear-cut cytoplasmic and/or surface positivity for the T-cell-associated antigens CD3, CD5, CD6 and CD4 (seven cases) or CD8 (one case), but consistently lacked B-cell and macrophage-associated markers. The best visualization of T-cell antigens was obtained in cytocentrifuge preparations and in areas of lymph node frozen sections that had been infiltrated by clusters of Hodgkin's and Reed-Sternberg cells. In two cases of Hodgkin's disease (nodular sclerosis, mixed cellularity) the neoplastic cells weakly expressed the B-cell antigens CD19 and CD22, but not T-cell or macrophage-associated markers. In 10 cases, Hodgkin's and Reed-Sternberg cells were negative for all the lymphoid- and macrophage-associated antigens. These results suggest a lymphoid (either T or B) rather than histiocytic origin for the Hodgkin's and Reed-Sternberg cells in a number of Hodgkin's disease cases.

Expression of lymphoid‐associated antigens on Hodgkin's and Reed‐Sternberg cells of Hodgkin's disease. An immunocytochemical study on lymph node cytospins using monoclonal antibodies

Monocytoid B-cell lymphoma.

Monocytoid B-lymphocytes are a B-cell subset present in subcapsular sinuses in some cases of lymphadenitis. We describe a case of lymphoma of this cell type. The tumour shows a distinctive morphology characterized by concentric strands of tumour cells around lymphoid follicles with hyperplastic germinal centres and conserved mantle zones. Electron microscopy of these cells shows short cellular processes as well as moderate development of endoplasmic reticulum. The phenotype of the tumour was monoclonal IgM-kappa, distinct from other node-based B-cell subpopulations and suggesting a possible relationship to the lymphocytes of the marginal zone present peripheral to lymphoid follicles of the spleen. Morphological features that suggest a relationship with hairy cell leukaemia are contrasted by phenotypic differences and the ultrastructural absence of ribosomic lamellar complexes.

Monocytoid B‐cell lymphoma, a tumour related to the marginal zone

The role of antibodies of CD15 as diagnostic markers of Hodgkin's disease was assessed from a review of the literature. A total of 571 cases of Hodgkin's disease and 386 cases of non-Hodgkin's lymphoma were included. The sensitivity of CD15 in detecting cases of Hodgkin's disease was 80% or 91% if cases of lymphocyte predominant Hodgkin's disease were excluded. The specificity of CD15 was only 80.6%, or in other words, 19.4% of cases of non-Hodgkin's lymphoma were CD15 positive. In an ideal test both the sensitivity and specificity would be 100% and if the test performance were no better than chance then they would both be 50%. It is concluded that CD15 immunostaining cannot be regarded as a sensitive or specific marker of Hodgkin's disease. Application of this formal method of analysis to other immunohistological reagents and panels of antibodies is discussed.

https://jcp.bmj.com/content/jclinpath/40/11/1298.full.pdf

Value of CD15 immunostaining in diagnosing Hodgkin's disease: a review of published literature.

The phenotype of 36 cases of hairy cell leukaemia has been investigated using a panel of monoclonal antibodies reactive with normal human lymphoid cells and with hairy cells. Staining was performed on frozen sections and/or cell smears by the recently developed APAAP immuno-alkaline phosphatase procedure. In about 90% of cases, neoplastic cells reacted strongly with antibodies against HLA-DR, leucocyte common antigen, B-cells (antibodies B1 and To15), hairy-associated antigens (antibodies KB-90, S-HCL3, HC2) and activated T-lymphocytes (antibodies anti-Tac and Tu69). The phenotype of 10% of cases was clearly different in that the neoplastic cells were negative or only weakly positive for one or more of the antigens recognized by HC2, anti-Tac and Tu69. Antibody HC1 reacted with tumour cells of only 50% of the hairy cell leukaemia cases investigated. Monoclonal antibody Ki-67 (which selectively detects proliferating cells) stained only a low percentage of cells in all but three of the cases studied. The neoplastic cells in all cases were unreactive with monoclonal antibodies anti-Leu1, Tu1, Tu33 and a meshwork of follicular dendritic cells was consistently absent from tissues infiltrated by hairy cells. The immunological phenotype associated with hairy cell leukaemia was not observed in any case of non-Hodgkin's lymphoma, suggesting that it represents a unique type of B-cell neoplasm.

Use of a panel of monoclonal antibodies for the diagnosis of hairy cell leukaemia. An immunocytochemical study of 36 cases.

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Use of a panel of monoclonal antibodies for the diagnosis of hairy cell leukaemia. An immunocytochemical study of 36 cases.