Hodgkin-like anaplastic large cell lymphoma (previously designated in the REAL classification) has same immunophenotypic features to classical Hodgkin lymphoma

• Published in: Leukemia & lymphoma 2007-01, Vol.48 (6), p.1127-1138
• Main Authors: Tamaru, Jun-Ichi, Tokuhira, Michihide, Nittsu, Nozomi, Nakamura, Shigeo, Ichinohasama, Ryo, Suzuki, Ritsuro, Mori, Hiraki, Takagi, Toshiyuki, Suzuki, Takahiro, Itami, Jun, Itoyama, Shinji, Mikata, Atsuo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; anaplastic large cell lymphoma; Anaplastic Lymphoma Kinase; anaplastic variant; Biomarkers, Tumor - genetics; BOB.1; cytotoxic molecule; Diagnosis, Differential; diffuse large B-cell lymphoma; Female; Gene Expression Regulation, Leukemic; Hodgkin Disease - diagnosis; Hodgkin Disease - genetics; Hodgkin Disease - mortality; Hodgkin Disease - pathology; Hodgkin lymphoma; Hodgkin-like ALCL; Humans; immunohistochemistry; Immunophenotyping; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - genetics; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Middle Aged; Neoplasm Staging; Oct.2; Octamer Transcription Factor-2 - genetics; PAX-5/BSAP; PAX5 Transcription Factor - genetics; Protein-Tyrosine Kinases - genetics; Receptor Protein-Tyrosine Kinases; Retrospective Studies; Survival Analysis; Trans-Activators - genetics
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428190701342000

In the WHO classification, the majority of Hodgkin-like ALCL cases as defined by the REAL classification are considered to be CHL. However, establishing a histological diagnosis for the gray zone between CHL and ALCL is often confusing. In this study, we re-evaluated such cases by performing immunohistochemistry with antibodies against PAX-5 BSAP, Oct.2, and BOB.1 OBF.1. Expression of PAX-5 BSAP was observed in 88% (76 87) of CHL specimens and none (0 11) of ALK-positive ALCL specimens. Among specimens of Hodgkin-like ALCL and ALK-negative ALCL, expression of PAX-5 BSAP was observed in 77% (20 26) and 18% (3 17), respectively. Most of the PAX-5 BSAP-positive specimens were negative for Oct.2 and or BOB.1 OBF.1 except for four CHL specimens. Our results may support the WHO classification in which most cases of Hodgkin-like ALCL are classified as CHL. However, the patients with Hodgkin-like ALCL with CHL-immunophenotype (PAX-5 BSAP-positive and negative for Oct.2 and or BOB.1) did not have a favorable outcome, with a 5-year OS rate of 58%.