Immunophenotypes of Reed-Sternberg cells and their variants: a study of 68 cases of Hodgkin's disease

Utilizing a panel of monoclonal and polyclonal antibodies, routine paraffin sections in 68 cases of Hodgkin's disease were examined for the presence of immunoreactivity in Reed-Sternberg (R-S) and related cells by the avidin-biotin-peroxidase complex (ABC) technique. In 14 cases of lymphocyte-predominant Hodgkin's disease (LPHD), R-S cells and the polyploid lymphocytic and histiocytic (L & H) variants of R-S cells were immunoreactive for L26 and alpha 1-antitrypsin (alpha 1-AT) in 9 (64%) and 6 (43%), respectively, whereas the remaining antibodies were negative or rarely positive against L & H variants of R-S cells. R-S cells in 24 cases of mixed cellularity Hodgkin's disease (MCHD) were positive with alpha 1-AT in 63% of cases, positive with LN3 in 71% of cases and positive for BerH2 in 92% of cases. The lacunar cell type of R-S cells in 19 cases of nodular sclerosing Hodgkin's disease (NSHD) were reactive for alpha 1-AT in all cases, BerH2 in 18 cases (95%), and LN3 in 17 cases (89%). Pleomorphic variant of R-S cells in 11 cases of lymphocyte depleted Hodgkin's disease (LDHD) showed reactivity with alpha 1-AT in 9 cases (82%), BerH2 in 6 cases (55%), and LN3 in 9 cases (82%). The incidence of L26 in R-S cells was higher in LPHD than in other three subtypes, whereas the immunohistochemical finding of alpha 1-AT had reverse relevance to the result of L26. The incidence of BerH2 in MCHD and NSHD was higher than that of this antibody in the whole of Hodgkin's disease. R-S cells in NSHD and LDHD were highly positive to LN3, and detection rate of these two types was higher than that in the whole of Hodgkin's disease. No cases showed immunoreactivity with anti-T-cell antibodies (CD3, UCHL1 and DFT1), a marker for natural killer cell (Leu7), and a marker for interdigitating reticulum cell (S-100 protein). These results suggest that correlation between predominant staining pattern and R-S cells and variants thereof in each histological subtype of Hodgkin's disease are as follows: LPHD shows L26+, alpha 1-AT-, BerH2-; MCHD and NSHD show L26-, alpha 1-AT+, BerH2+; and LDHD shows L26-, alpha 1-AT+, BerH2+ or L26+, alpha 1-AT+, BerH2-.