AUTHORS' REPLY. HOW TO DIFFERENTIATE BETWEEN T-CELL-RICH B-CELL LYMPHOMA AND LYMPHOCYTE-PREDOMINANT HODGKIN'S DISEASE. EVIDENCE FOR THE VALUE OF MB1 AND 4KB5 IMMUNOSTAINING
✍ Scribed by SCHMIDT, U.; HERBST, J.; METZ, K. A.; LEDER, L.-D.
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 159 KB
- Volume
- 181
- Category
- Article
- ISSN
- 0022-3417
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✦ Synopsis
We thank Drs Ashton-Key and Isaacson for their interest in our paper. In a similar study on CD45 immunostaining of TCRBCL and LPHD, they found L+H cells positive for either CD45RA (4KB5, 5/12) or CD45RO (UCHL1,7/12). In our series, the L+H cells were found to be 4KB5-as well as UCHL1-negative in 8/11 cases.
LCA immunostaining was omitted from our LPHD cases, because LCA does not discriminate between TCRBCL and LPHD. Nevertheless, we are convinced that our cases represent true L+H Hodgkin's disease, because the neoplastic cells were CD20 (L26)-positive as well as CD30 (BerH2)-and CD15 (LeuM1)-negative. We think all would agree that this pattern is not compatible with Hodgkin's and Sternberg Reed cells of the classical type.
Certainly, a LCA-positive cell should express either UCHL1 or 4KB5 and the neoplastic cells of LCL, as a rule, will behave in this manner. It is, however, less clear to what extent this holds true also for the L+H cells of LPHD. Hodgkin's cells, including the L+H variant, show heterogeneity of marker expression to a much greater extent than is the case with LCL cells: staining characteristics of Hodgkin's cells are described to vary from case to case and even within any single case. Furthermore, LCA positivity is often seen to be restricted to subsets of the L+H cells. In addition, many cases occur with L+H cells being completely LCA-negative. Our finding of UCHL1 negativity of L+H cells in all of our LPHD cases is well in accordance with the literature. We agree that it would be interesting to find out whether or not LPHD cases lacking 4KB5 will express another LCA isoform.