EPISODE 1: 59yrs old male with diagnosis of cHL (MC) in 2007 (CD30+ CD15- CD20- CD3-) from supraclavicular node (clin. suspition of mts). An appropriate therapy was administered. THE MATERIAL IS NOT ACCESSIBLE FOR REVIEW FOR A MOMENT.
HISTO(DECRIPTION ONLY): LN with obliterated architecture: vague T nodules/zones between residual B follicles and B cell agregates. Interstitial multiple mediom- large sized CD30+ cells with vesiculated/lobated nuclei. CD21+ FDC oval networks in B follicles: giant cells focally occupate these follicles in mantle pattern.
IH description: Giant cells: CD30 (+/+++)(cytopl.- membr. Golgi) 90%, CD15/EMA/EBV LMP1(-), Mum1 (+/++) 10% (nuclear), Bcl6(+/++) 40% (nuclear); FDC networks CD21+; Multiple CD138+/EMA+/Mum1+ plasmocytes, esp. in the sinuses in periphery of tumor; INFILTRATION OVERALL: CD3+ >CD20+; Bcl2+ mantle zones and aprt of T population (20%); CD3+ T population: CD4/CD8 ~2/1.
EPISODE 2: Nowadays (2009 february): LN biopsy from the groin region.
HISTO: Difuse T pleomorphic infiltration with medium-sized CD30+CD15- cells.
PCR: IgH/IgKapa: CLONAL. TCR gama/beta: CLONAL.
IH: CD30(+/+++)(citopl.- Golgi r.- membr.) medium-large sized cells: 10% population: CD15(+/+++) 20% (membr.- citopl.- Golgi r. r-ja), EBV EBER/EBV LMP1(-), LCA? (difficult interpretation, most probasbly +), CD20(+/+++) 80% (membr.), ALK1(-), CyclinD1(-), Bcl6(++) 100% (nuclear).
INFILTRATE OVERALL: LCA(++/+++) 90% (membr.- cytopl.), CD3(+++) 75% (cytopl.), CD20/CD79a (+++)(cytopl.)(in periphery of T "nodules") 10%. CD138+/CD79a+ > CD20+ plasmoid cells about 15%: Ig kappa(++)(cytopl.)/Ig lambda apie 4/1 (!). Ki67 about 30% (+++)(nuclear).
T POPULATION: CD3/CD2/CD5(+++) 100% (cytopl.), CD4/CD8+ about 2-3/1, CD7+ 30%. GranzymB+ ~ 20% (++)(dot cytopl.). CD10+ lymphos ~5%. CD57+ lymphos with irregular nuclei ~30%.
Prominent nodular and irregular FDC proliferation: CD21+>CD21+.
PROPOSAL: Peripheral T lymphoma NOS/AILT vs cHL (MC).
QUEST: 1. Interpretation of clonality studies.
HL is moving to T-NHL (AILT)