Discordant CD3 expression in lymphomas when studied on frozen and paraffin sections

The results of CD3 staining in the T or putative natural killer (NK) cell lymphomas of nasal and extranasal sites as reported in the literature have been confusing, with some studies reporting a low rate of CD3 positivity and others a high frequency of CD3 staining. The former studies were performed on fresh or frozen tissues, whereas the latter were performed on paraffin sections using a polyclonal antiserum (poly-CD3). Although previous studies have suggested a high concordance rate of CD3 staining between fresh/frozen tissues and paraffin sections, many CD3- cases have not been studied, and the more reliable antigen retrieval techniques have not been applied. In this study, we addressed the question of discordant CD3 expression by comparing the results of CD3 staining in lymphomas as studied on frozen sections and as studied on paraffin sections (with antigen retrieval effected by pressure cooking). This series was biased toward inclusion of a high percentage of cases of putative NK cell lymphomas, which are prevalent among Asians and usually show a CD2+ CD3(Leu4)- CD56+ immunophenotype. Among 35 cases of CD3(Leu4)- T- and T/NK-cell lymphomas, 30 (86%) showed staining with poly-CD3 on paraffin sections. All 15 CD3(Leu4)+ T-cell lymphomas showed positive staining with poly-CD3 on paraffin sections. None of 60 B-cell lymphomas were stained by poly-CD3, confirming no loss of specificity of staining with this antiserum despite use of an effective antigen-retrieval technique. The discordance rate of CD3 staining in T- and T/NK-cell lymphomas in this series was 60%, and this phenomenon was most commonly observed in the CD56+ T/NK-cell lymphomas: CD3(Leu4)- in frozen sections but poly-CD3+ in paraffin sections. Therefore, to avoid confusion, we propose designating the results based on fresh/frozen tissues CD3(f) and those based on poly-CD3 application on paraffin sections CD3(p) in future reporting of CD3 immunophenotype.