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Coexpression of CD15 and CD20 by Reed-Sternberg cells in Hodgkin's disease
L R Zukerberg1, A B Collins, J A Ferry
1James Homer Wright Pathology Laboratory, Massachusetts General Hospital, Boston 02114.
Insights
Reed-Sternberg cells in Hodgkin's disease show varied B-cell marker CD20 and granulocyte antigen CD15 expression. This antigen coexpression may indicate an unstable intermediate, explaining immunophenotype heterogeneity in Hodgkin's disease.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- The immunophenotype of Reed-Sternberg cells in Hodgkin's disease is heterogeneous.
- This heterogeneity creates uncertainty regarding the normal counterpart of Reed-Sternberg cells.
Purpose of the Study:
- To investigate the coexpression of B-cell marker CD20 and granulocyte-associated antigen CD15 on Reed-Sternberg cells.
- To explore the relationship between antigen expression and tumor characteristics in Hodgkin's disease.
Main Methods:
- Utilized double-labeling techniques and serial section staining.
- Analyzed 20 cases of nodular sclerosis and mixed cellularity Hodgkin's disease.
Main Results:
- Coexpression of CD20 and CD15 was observed in Reed-Sternberg cells in 3 out of 20 cases.
- CD20 expression correlated with monomorphic cell proliferation, while CD15 expression was linked to increased granulocyte infiltrate.
- No correlation was found with fibrosis, plasma cells, or histiocytes.
Conclusions:
- Results suggest a continuum of antigen expression on Reed-Sternberg cells, potentially involving antigen switching.
- Coexpressing cells might represent an unstable intermediate.
- Tumor microenvironment may influence antigen expression, explaining immunophenotypic heterogeneity.
Abstract:
The immunophenotype of the Reed-Sternberg cells in Hodgkin's disease is heterogeneous among different cases; this heterogeneity has contributed to the continuing uncertainty regarding the normal counterpart of the Reed-Sternberg cell. In this study, the authors demonstrate coexpression of the B-cell marker, CD20, and the granulocyte associated antigen, CD15, by Reed-Sternberg cells in three of 20 cases of nodular sclerosis and mixed cellularity Hodgkin's disease using a double-labelling technique in one case and staining of serial sections in three cases. Additionally, the authors found that expression of CD20 occurred more often in tumors with a monomorphous proliferation of mononuclear and binucleate Hodgkin's and Reed-Sternberg cells, without numerous eosinophils or polymorphonuclear neutrophils. In contrast, expression of CD15 by Reed-Sternberg cells was associated with a greater granulocyte infiltrate. The presence or absence of fibrosis, plasma cells, and histiocytes did not correlate with antigen expression. These results suggest that there may be a continuum of antigen expression by Reed-Sternberg cells, with some cells expressing CD20, some CD15, and others expressing both antigens; cells coexpressing both CD15 and CD20 may represent an unstable intermediate in the process of antigen switching. The possibility that antigen expression by the neoplastic cells in a given case may modulate depending on the background infiltrate could explain the heterogeneity of immunophenotype among cases of Hodgkin's disease.