GATA3 Immunohistochemical Staining in Classical Hodgkin Lymphoma and Its Diagnostic Utility in Differential Diagnosis

Classical Hodgkin lymphoma (CHL) is a common lymphoid neoplasm with a wide range of differential diagnoses. Although it has a specific immunophenotype, aberrant expression of antigens can cause problems at its diagnosis. In this study we evaluated the usefulness of GATA3 in the differential diagnosis of CHL.

One hundred cases of CHL and a control group of 106 lymphoma cases, which included anaplastic large-cell lymphoma both positive and negative for anaplastic lymphoma kinase (ALK), Epstein-Barr virus (EBV)-positive large B-cell lymphoma, T-cell/histiocyte-rich B-cell lymphoma, primary mediastinal large B-cell lymphoma, nodular lymphocyte-predominant Hodgkin lymphoma, and mediastinal gray-zone lymphoma, were included in the study. GATA3 immunohistochemistry was applied to all cases and nuclear expression was accepted as positive. Expression status of GATA3 was compared between the CHL group and the control group, as well as among each lymphoma subtype. In addition, whether the biopsy type affected diagnostic performance was assessed. For CHL, the relationship with EBV status and GATA3 expression was evaluated.

GATA3 expression was significantly higher in CHL cases compared to the control group (p<0.001). When compared among individual subgroups, GATA3 was found to be useful in the differential diagnosis of all except for ALK-negative anaplastic large-cell lymphoma (p=0.678) and mediastinal gray-zone lymphoma (p=0.327). GATA3 expression was significantly higher in EBV-negative CHL (p=0.02). In core-needle biopsies, the diagnostic performance was limited (p=0.178).

GATA3 is a useful marker for differentiating CHL from B-cell non-Hodgkin lymphomas but its efficiency is limited in ALK-negative anaplastic large-cell lymphoma and mediastinal gray-zone lymphoma. Due to heterogeneous reactions, its diagnostic value is limited in core-needle biopsies.