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Updated: Aug 8, 2026
Flow-sorting and Exome Sequencing of the Reed-Sternberg Cells of Classical Hodgkin Lymphoma
Published on: June 10, 2017
Expression of B-cell markers in classical hodgkin lymphoma: a tissue microarray analysis of 330 cases
Alexandar Tzankov1, Annette Zimpfer, Ann-Christine Pehrs
1Institute of Pathology, University of Basel, Basel, Switzerland.
Insights
Classical Hodgkin lymphoma cells originate from B-lymphocytes, but B-cell markers like CD20 are often absent. This study found B-cell markers are expressed in 38% of classical Hodgkin lymphoma cases, with CD20 being the most common.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Classical Hodgkin lymphoma (cHL) is a malignancy of B-lymphocyte origin.
- However, classical B-cell markers such as CD20 are expressed in a minority of cHL cases, complicating lineage determination.
Purpose of the Study:
- To investigate the expression of B-cell-related antigens (CD20, CD79a, CD138) in classical Hodgkin lymphoma.
- To evaluate the utility of tissue microarray (TMA) technology for assessing heterogeneously expressed markers in cHL.
Main Methods:
- A tissue microarray was constructed from 330 classical Hodgkin lymphoma cases.
- Immunohistochemistry was used to assess the expression of CD15, CD20, CD30, CD79a, CD138, and Epstein-Barr virus latent membrane protein 1.
- Methodology was validated by comparing TMA results with conventional sections, and the impact of core number on CD20 expression was analyzed.
Main Results:
- Of 253 representative cases, CD20 was expressed in 33%, CD79a in 10%, and CD138 in 1%.
- CD20 and CD79a were co-expressed in 16 cases, and CD20 expression inversely correlated with CD15.
- TMA results for CD20 showed 94% concordance with conventional sections; using two cores per sample was found to be representative for CD20 expression.
Conclusions:
- B-cell markers are expressed in 38% of classical Hodgkin lymphoma cases, in the order CD20 > CD79a >> CD138.
- Tissue microarray technology, particularly with two cores per sample, is a reliable and efficient method for high-throughput evaluation of heterogeneously expressed markers in cHL.
Abstract:
Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma arise from B-lymphocytes. However, classical markers of the B-cell phenotype, such as CD20, are present only in about 25% of the cases. The aim of the present study was to assess expression of the B-cell-related antigens CD20, CD79a, and CD138 in classical Hodgkin lymphoma using a tissue microarray consisting of 330 classical Hodgkin lymphoma cases. Expression of CD15, CD20, CD30, CD79a, CD138, and latent membrane protein 1 of Epstein-Barr virus was assessed by immunohistochemistry, and the methodology was validated by direct comparison of CD20 expression on the tissue microarray cores with corresponding large sections. The influence of the number of arrayed sample cores on the obtained expression levels of CD20 was analyzed by comparing the results from single, duplicate, and triplicate cores. Two-hundred fifty-three (77%) of the 330 cases were morphologically representative. CD20 was expressed in 84 cases (33%), CD79a in 26 (10%), and CD138 in 2 (1%), respectively. CD20 and CD79a were co-expressed in 16 cases (P <.005), and expression of CD20 correlated inversely with CD15 (P <.01). Comparing the tissue microarray results with those from conventional sections for expression of CD20 yielded a concordance of 94% (63/67). Examining one, two, and three cores from individual cases revealed positivity for CD20 at 24% (61/253), 32% (82/253), and 33% (84/253), respectively. We conclude that B-cell markers are expressed in 38% of classical Hodgkin lymphoma in the following rank order: CD20>CD79a>>CD138. The use of two cores per tissue sample renders the tissue microarray technology effectively representative and thus very useful for high-throughput evaluation of heterogeneously expressed markers in classical Hodgkin lymphoma.
