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[A case of cervical progressive transformation of germinal center]

Hiroshi Kimura1, Yosuke Tajika

  • 1Department of Otolaryngology, Saiseikai Toyama Hospital, Toyama.

Nihon Jibiinkoka Gakkai Kaiho
|May 10, 2012
PubMed

Insights

Progressive transformation of the germinal center (PTGC) is a rare borderline disease causing enlarged lymph nodes. This case highlights its presentation in otolaryngology and the importance of accurate diagnosis to avoid misclassification as lymphoma.

Area of Science:

  • Otolaryngology
  • Pathology
  • Immunology

Background:

  • Progressive transformation of the germinal center (PTGC) is an uncommon condition characterized by abnormal germinal center enlargement, often presenting as lymphadenopathy.
  • Reports of PTGC within otolaryngology are infrequent, posing diagnostic challenges.

Observation:

  • A 41-year-old male presented with bilateral cervical lymphadenopathy and hoarseness.
  • Initial fine needle cytology was inconclusive, leading to medical observation.
  • Otolaryngological examination revealed mild bilateral lymphadenopathy, prompting surgical excision for diagnosis.

Findings:

  • Histopathological examination confirmed PTGC in the submandibular lymph nodes.
  • Immunostaining revealed an elevated IgG4+ cell count, with an IgG4/IgG ratio of 50%.

Implications:

  • PTGC can be mistaken for Hodgkin's lymphoma, necessitating increased awareness among otolaryngologists.
  • Accurate diagnosis of PTGC is crucial for appropriate patient management and avoiding unnecessary treatments.
  • This case underscores the importance of thorough pathological evaluation for unexplained lymphadenopathy in the head and neck region.

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