A Comparative Immunohisto chemical Diagnosis of Hodgkin’s lymphoma with Conventional Method

Document Type : Research Paper


1 professor of pathology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad,Iran

2 Assistant professor, Imam Reza Hospital,Mashhad University of Medical Sciences,Mashhad,Iran

3 Anatomical & Clinical pathologist

4 Statistical Consultant, Mashhad University of Medical Sciences,Mashhad,Iran

5 Medical Student,Mashhad University of Medical Sciences,Mashhad,Iran


Hodgkin’s lymphoma is a malignant neoplasm of B lymphocytes and less common T lymphocytes that morphologically can be mistaken with several benign and malignant diseases. These diseases have different course, treatments and prognosis from Hodgkin’s lymphoma. Immunohistochemical staining is very useful that will aid in separating Hodgkin’s Lymphoma from a series of benign and malignant lookalikes.
Materials and Methods
We Randomly selected 53 cases with primary diagnosis of Hodgkin’s lymphoma in pathology laboratory of Imam Reza Hospital from 1374-1384. to confirm or rule out of the primary diagnosis, microscopic evaluation and Immunohistochemical staining were done.
Overall in 47 cases (88.7%), Hodgkin’s lymphoma was confirmed and 6 cases (11.3%) were non hodgkin lymphoma.A total 5 cases were T cell Rich large B cell lymphoma and 1 case was anaplasic large cell lymphoma probably. In Hodgkin’s lymphoma cases, the mean age was 40 years. Except for nodular sclerosis other types were more frequent in males. (M/F = 2.5).The commonest type was mixed cellularity (39 cases) (54.7%).
Misdiagnosis of Hodgkin’s lymphoma without Immunohistochemical staining was 11.3%. Because of significant difference between treatment and prognosis of Hodgkin’s lymphoma and other morphologically similar diseases, immunohistochemical staining particulary in lymphocytic depletion and nodular lymphocytic predominant Hodgkin’s lymphoma, is necessary and recommended.


1- Armitage JO, Longo DL. Malignancies of lymphoid cells. In: Kasper DL. Harrison’s principles of internal medicine.
17th ed. New York: Mc Graw- Hill; 200.p. 641- 650.
2- Iochim H, Ratech H. Hodgkin lymphoma. In: Iochim H, Ratech H.Lymph Node Pathology. 4thed. New York:
Lippincott Williams & wilkins; 2009.p.327- 348.
3- Fraga M, Sanchez L, Forteza, Forteza J, García-Rivero A, Piris MA. T cell rich B cell lymphoma is a disseminated
aggressive neoplasm differential diagnosis from Hodgkin’s lymphoma. Histopathology 2002; 41:216- 29.
4- Karimi M, Yarmohammadi H, Ghavanini AA, Kumar PV. Epidemiological surveillance of pediatric Hodgkin’s
disease in southern Iran. Med Sci Monit 2002; 8:572-575.
5- Almars NM. Hodgkin’s lymphoma in North Jordan. Saudi Med J 2004; 25:1917-1921.
6- Rosai J. lymph node. In: Rosai J. Rosai and Ackerman’s surgical pathology.9 th ed. New York: Mosby; 2004.p.1917-
7- Pileri SA, Ascani S, Leoncinil L,Sabattini E, Zinzani PL,Piccaluga PP, et al. Hodgkin’s lymphoma the pathologist
viewpoint. J Clin Pathol 2002; 55:162-176.
8- Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, et al. A revised European American Classification of
lymphoid neoplasm. Blood 1994; 84:1361-1392.
9- Schnitzer B. Hodgkin Lymphoma . Hematol Oncol Clin North Am 2009; 23:747-768.
10- Chan J. Tumors of the lymphoreticular system. In: Diagnotic histopathology of tumors. 2 th ed. London: Churchill
Livigstone; 2000. p. 112- 128.
11- Kadin M. Hodgkin’s lymphoma. In: Dabbs D. Diagnostic Immunohistochemistby:diagnostic, theranostic and
genomic applications .3rd ed. Philadelphia: Saunders – Elsevier ; 2009.p.135- 145.
12- Listinsky CM. A practical approach to diagnosis to the diagnosis of Hodgkin lymphoma. Am J Clin Pathol 2002;
117:76- 94.
13- Charafe E. Characterization of Hodgkin’s lymphoma like undifferentiated carcinoma of the nasopharynged type as
a particular UCNT Subtype mimicking Hodgkin’s lymphoma .J Oncol 2003; 23:97- 103.
14- Liu Y, Zhung H, Liao X. Immunophenotype and differential diagnosis of Hodgkin’s lymphoma . Zhonghua Xue Ye
Xue Za Zhi 2002; 23:524-527.
15- Kansal R, singleton TP, Ross CW, Finn WG, Padmore RF, Schnitzer B.. Follicular Hodgkin lymphoma. Am J Clin
Pathol 2002; 117:29- 35.
16- Higgins RA, Blankenship JE, Kinney MC. Application of immunohistochemistry in the diagnosis of non-Hodgkin
and Hodgkin lymphoma. Arch Pathol Lab Med 2008; 132:441-461.
 17-Gazal D,Andre H,Mounier N. Pathologic and clinical features of 77 Hodgkin’s lymphoma patients treated in a
lymphoma protocol. Am J Surg Pathol 2001; 25:297-306.
18- Iraj Ak . Hodgkin’s disease: assessment of treatment and survival rates in Iran. Asian Pac Cancer Prev 2004; 5:379-
19- Jose BO, Koerner P, Spanos WJ, Paris KJ, Silverman CL, Yashar C, et al. Hodgkin’s lymphoma in adult. J ky Med
Assoc 2005; 103:15-7.
20- Boudova L, Torlakovic E. Nodular lymphocyte predomimant Hodgkin l ymphoma with nodular resembling T cell
rich B cell lymphoma: differential diagnosis. Blood 2003; 102:3753-3756.
 21- Rudiger T, Ott G, Ott MM. Diffrential diagnosis between classic Hodgkin’s lymphoma , T- cell – rich – B – cell
lymphoma by immunohistochemistry. Am J Surg Pathol 1998; 22:1184-1191.
22- Aki H, Tuzune N, Seniz O , et al . T cell rich B cell lymphoma: a clinicopathologic study of 21 cases. Leukemic
Research 2004; 28(3): 229- 236.
23- Browne P, Petrosyan k , Hernandez A, Chan JA.The B cell transcription factors BSAP, Oct -2 and BOB and the pan
B cell markers CD20 , CD 22, and CD79 are useful in the differential diagnosis of classical Hodgkin lymphoma. Am J
Clin Pathol 2003; 120:767-777.
24- Achten R.Nodular lymphocyte predominant Hodgkin’s Lymphoma and T cell histiocyte rich large B cell
lymphoma. Haematol Pathol 2004; 10:385- 393.
25- Vassallo J, lamant L, Brugieres L, Gaillard F, Campo E, Brousset P, et al. ALK positive Anaplastic large cell
lymphoma mimicking Nodular sclerosis Hodgkin’s lymphoma. Am J Surg Pathol 2006; 30:223- 228.