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Ultrasensitive RNA In Situ Hybridization for Kappa and Lambda Light Chains Assists in the Differential Diagnosis of Nodular Lymphocyte-predominant Hodgkin Lymphoma
The American Journal of Surgical Pathology ( IF 5.6 ) Pub Date : 2022-08-01 , DOI: 10.1097/pas.0000000000001881
Hatem Kaseb 1 , Zhen Wang , James R Cook
Affiliation  

Establishing a diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (nLPHL) is often challenging as the differential diagnosis is broad, including classic Hodgkin lymphoma (cHL), progressive transformation of germinal centers (PTGC), and other lymphoproliferative disorders. In this study, we investigate the utility of a recently described ultrasensitive in situ hybridization assay for kappa and lambda immunoglobulin light chains in distinguishing nLPHL, cHL, and PTGC. A total of 72 cases were examined (21 nLPHL, 33 cHL, and 18 PTGC). In nLPHL, the large neoplastic cells were light chain restricted in 21/21 (100%) cases (16 kappa, 5 lambda). In contrast, Reed-Sternberg cells of cHL were negative for kappa and lambda in all cases (0/33, 0%; P<0.001). In PTGC, polytypic B cells were noted in mantle zones and germinal centers in all cases, with 1 case (5%) also showing focal collections of light chain restricted large B cells. Background monotypic small B cells were identified in 3 cases, including 1 nLPHL and 2 cHL (1 of which arose in chronic lymphocytic leukemia). Ultrasensitive in situ hybridization for kappa and lambda is a useful addition to a standard immunophenotyping panel for the evaluation of suspected nLPHL.



中文翻译:

Kappa 和 Lambda 轻链超灵敏 RNA 原位杂交有助于结节性淋巴细胞为主的霍奇金淋巴瘤的鉴别诊断

结节性淋巴细胞为主的霍奇金淋巴瘤 (nLPHL) 的诊断通常具有挑战性,因为鉴别诊断范围广泛,包括经典霍奇金淋巴瘤 (cHL)、生发中心进行性转化 (PTGC) 和其他淋巴增殖性疾病。在本研究中,我们研究了最近描述的 kappa 和 lambda 免疫球蛋白轻链超灵敏原位杂交测定在区分 nLPHL、cHL 和 PTGC 中的效用。总共检查了 72 例病例(21 例 nLPHL、33 例 cHL 和 18 例 PTGC)。在 nLPHL 中,21/21 (100%) 病例的大肿瘤细胞受到轻链限制(16 kappa,5 lambda)。相比之下, cHL 的Reed-Sternberg 细胞在所有病例中 kappa 和 lambda 均为阴性(0/33,0%;P <0.001)。在 PTGC 中,所有病例的地幔区和生发中心均发现多型 B 细胞,其中 1 例 (5%) 还显示轻链限制性大 B 细胞的局灶性集合。3 例中发现背景单型小 B 细胞,其中 1 例为 nLPHL,2 例为 cHL(其中 1 例出现于慢性淋巴细胞白血病)。kappa 和 lambda 超灵敏原位杂交是对标准免疫表型分析组的有用补充,用于评估可疑的 nLPHL。

更新日期:2022-07-19
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