Nodal involvement by cutaneous CD30-positive T-cell lymphoma mimicking classical hodgkin lymphoma

Franziska C. Eberle, Joo Y. Song, Liqiang Xi, Mark Raffeld, Nancy Lee Harris, Wyndham H. Wilson, Stefania Pittaluga, Elaine S. Jaffe

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

An association between classical Hodgkin lymphoma (cHL) and mycosis fungoides (MF) or lymphomatoid papulosis has been reported in the literature. However, there can be considerable morphologic and immunophenotypic overlap between cHL and nodal involvement by CD30-positive T-cell lymphoproliferative disorders (CD30-T-LPD). To examine this potential association, biopsies from patients with a history of MF or primary cutaneous CD30-T-LPD and lymph node biopsies reported as either CD30-positive T-cell lymphoma (TCL) with Hodgkin-like cells or cHL were retrieved from the authors' institution. Of 11 cases identified, 10 were considered CD30-positive TCL with Hodgkin-like cells, whereas 1 was confirmed as cHL upon review. Five cases originally diagnosed as cHL were revised as CD30-positive TCL. Cases of CD30-positive TCL with Hodgkin-like cells showed a male predominance (M:F, 4:1) with a median age of 53 years (range, 44 to 72 y). Nearly all patients (9/10) initially presented with skin lesions. In 7/10 patients the draining lymph node was involved, whereas in 3 cases this could not be confirmed. Tumor cells morphologically resembled Hodgkin/Reed-Sternberg cells; they were uniformly strongly positive for CD30, and CD15 was expressed in 9/10 (90%) cases. A T-cell derivation was confirmed by T-cell antigen expression (7/10) and clonal rearrangement of T-cell receptor genes (9/10). In 3 cases a common T-cell clone was identified in skin and lymph node. B-cell markers (CD20/PAX5) were consistently negative. In 1 case the diagnosis of cHL followed by lymphomatoid papulosis was confirmed, with Hodgkin/Reed-Sternberg cells expressing PAX5, CD30, and CD15. In situ hybridization studies for Epstein Barr virus were negative. We show that cHL is less often associated with MF and primary cutaneous CD30-T-LPD than previously thought and that the coexpression of CD30 and CD15 in these TCLs may lead to a mistaken diagnosis of cHL.

Original languageEnglish (US)
Pages (from-to)716-725
Number of pages10
JournalAmerican Journal of Surgical Pathology
Volume36
Issue number5
DOIs
StatePublished - May 2012
Externally publishedYes

Keywords

  • CD30-positive T-cell lymphoma
  • classical Hodgkin lymphoma
  • lymphomatoid papulosis
  • mycosis fungoides
  • primary cutaneous CD30-positive T-cell lymphoproliferative disorder
  • transformation

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

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  • Cite this

    Eberle, F. C., Song, J. Y., Xi, L., Raffeld, M., Harris, N. L., Wilson, W. H., Pittaluga, S., & Jaffe, E. S. (2012). Nodal involvement by cutaneous CD30-positive T-cell lymphoma mimicking classical hodgkin lymphoma. American Journal of Surgical Pathology, 36(5), 716-725. https://doi.org/10.1097/PAS.0b013e3182487158