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[IgD expression in various immunoarchitectural patterns of nodular lymphocyte predominant Hodgkin lymphoma in
M A Senchenko1, D M Konovalov1
1Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
Insights
This study found that 50% of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) cases in children express IgD. IgD positivity was significantly associated with atypical NLPHL patterns, suggesting potential biological differences.
Area of Science:
- Immunopathology
- Pediatric Oncology
- Hematopathology
Context:
- Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare lymphoid neoplasm.
- Lymphocyte predominant (LP) cells in NLPHL typically originate from germinal centers.
- LP cells expressing IgD, a marker of naive B-cells, is unusual and its frequency in NLPHL is not well-established.
Purpose:
- To determine the frequency of IgD expression in pediatric NLPHL cases.
- To assess the association between IgD positivity and immunoarchitectural patterns in NLPHL.
Summary:
- IgD expression was detected in 50% (26/52) of pediatric NLPHL cases.
- A significant positive correlation was observed between IgD expression and atypical NLPHL patterns (72.4%) compared to typical patterns (21.7%).
- Pattern C was the most frequent among IgD-positive atypical cases.
Impact:
- IgD expression is a frequent finding in pediatric NLPHL, aiding in differential diagnosis.
- The association of IgD positivity with atypical patterns suggests distinct biological characteristics within NLPHL.
- This finding may contribute to understanding NLPHL heterogeneity and refining diagnostic approaches.
Background:
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) consist of lymphocyte predominant cell or LP-cell. Despite their origin from active germinal centers, in some cases LP-cells express IgD, which is characteristic of naive B-lymphocytes of the mantle zone. Due to the rarity of NLPHL, assessing the frequency of IgD-positive cases is difficult. This marker can serve not only for differential diagnosis with other diseases, but also indicate the possible heterogeneity of NLPHL, which is currently represented by six immunoarchitectural patterns.
Objective:
To determine the frequency of IgD-positive cases of NLPHL in children with subsequent assessment of the association with types of immunoarchitectural patterns.
Material And Methods:
The study included 52 cases of NLPHL, which were divided to typical and atypical patterns. Differences between two groups were compared using Fisher's exact tests.
Results:
IgD expression was found in LP-cells in 26 of 52 cases (50%) and was positively correlated with atypical types (typical - 5/23, 21.7% vs atypical - 21/29, 72.4%, p=0.0003), among which pattern C was most common.
Conclusion:
Due to the high incidence of IgD-positive cases in NLPHL, this marker may be useful in differential diagnosis with histologic mimics. At the same time, positive IgD status was associated with atypical patterns, which may likely determine the different biology of neoplastic cells within the same form.
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