TABLE 4.
Immunohistochemical Features of NLPHL With Atypical T Cells
| LP Cell Immunophenotype |
T-Cell Immunophenotype |
||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Case | CD20 | CD30 | CD15 | IgD | Pan- T* |
CD4 vs. CD8 pre-dominance † | CD45RA vs. CD45RO Pre-dominance | CD10 | bcl-6 | CD57 | PD-1 | T-bet | CD25 | FOXP3 | Perforin | Gran-zyme B |
Ki67 PI |
| 1 | + | – | – | ND | + | Equal | CD45RO | ND | ND | ND | ND | ND | ND | ND | ND | ND | 40% |
| 2 | + | – | – | + | + | CD8 | Equal | – | Rare | Rare | – | Many | Many | Rare | Occ | Occ | 40% |
| + | + | + | + | + | + | + | |||||||||||
| 3 | + | – | – | + | + | CD4 | CD45RO | – | Rare | Occ | Occ | Many | Many | Rare + | Rare + | Occ | 30% |
| + | + | + | + | + | + | ||||||||||||
| 4 | + | – | – | ND | + | ND | CD45RO | ND | ND | – | ND | ND | ND | ND | ND | ND | ND |
| 5 | + | – | – | ND | + | CD4 | CD45RO | ND | ND | – | ND | ND | ND | ND | ND | ND | ND |
| 6 | + | – | – | + | + | CD4 | CD45RO | – | Rare | – | – | ND | ND | Rare + | Rare + | Rare | 20% |
| + | + | ||||||||||||||||
| 7 | + | – | – | + | + | CD4 | CD45RO | – | – | – | Occ | ND | Rare | Rare + | – | Rare | ND |
| + | + | + | |||||||||||||||
| 8 | + | +‡ | – | – | + | CD4 | ND | Rare | Many | ND | Many | ND | ND | ND | ND | ND | 50% |
| + | + | + | |||||||||||||||
| 9 | + | +‡ | – | + | + | CD4 | ND | ND | Many | Rare | ND | ND | ND | ND | ND | ND | 40%§ |
| + | + | ||||||||||||||||
| 10 | + | – | – | – | + | CD4 | Equal | – | ND | Occ | Occ | Rare | – | – | Rare + | Rare | 30% |
| + | + | + | + | ||||||||||||||
| 11 | + | – | – | + | + | ND | CD45RA | ND | ND | ND | ND | ND | ND | ND | ND | ND | 25% |
indicates positive; –, negative; IgD, immunoglobulin D heavy chain; ND, not done; Occ, occasional; PI, proliferation index. The proportion of T cells staining positively for CD10, bcl-6, CD57, PD-1, T-bet, CD25, FOXP3, perforin, and granzyme B was quantified as follows: rare, < 10% of cells; occasional, 10% to 30% of cells; many, 30% to 50% of cells; most, >50% of cells.
Pan-T-cell antigens tested in each case: cases 1, 2, 3, 6, and 7: CD2, CD3, CD5, CD7, and CD43; case 4: CD43; cases 5 and 11: CD3 and CD43; case 8: CD3 and CD5; case 9: CD2, CD3, CD5, and CD7; case 10: CD2, CD3, CD5, and CD43.
Determined by flow cytometry and immunohistochemistry in cases 8 and 10, by flow cytometry alone in case 9, and by immunohistochemistry alone in all other cases tested.
A small subset of LP cells showed weak staining for CD30 in these cases, but LP cells were strongly CD20+ and positive for bcl-6, OCT2, and BOB.1.
Performed on the patient’s second lymph node biopsy showing relapsed disease.