The Value of CD23 Expression as an Additional Marker in Distinguishing Mediastinal (Thymic) Large B-Cell Lymphoma From Hodgkin Lymphoma

Abstract

Mediastinal diffuse large B-cell lymphoma (Med-DLBCL) is a subtype of DLBCL that has morphologic and clinical similarities and phenotypic overlaps with classical Hodgkin lymphoma (CHL) involving the mediastinum. CD23 is a marker that has been previously reported in Med-DLBCI and is proposed in the differential diagnosis of M-DLBCL and CHL. A panel of immunostains, including CD45, CD20, CD3, CD30, CD15, CD21, and CD23 as well as Eber was performed on Med-DLBCL and 20CHL. 23/27 Med-DLBCL (85%) were positive for CD23 (membranous) CD30 was negative in 6 and positive in 21 cases. 18 CHL cases were negative for CD23 and only 2 showed rare scattered Reed-Sternberg cells with weak cytoplasmic CD23 staining. CD23 showed a sensitivity of 85% and positive predictive value of 92%. In conclusion CD23 is a useful marker in distinguishing Med-DLBCL and CHL in mediastinal biopsies and may be helpful as an adjunct to histomorphology and other markers in the diagnosis and appropriate clinical management of these lesions.

Utility of CD200 immunostaining in the diagnosis of primary mediastinal large B cell lymphoma: comparison with MAL, CD23, and other markers

“…Useful immunophenotypic markers for this purpose include CD15, a well-established marker of classical Hodgkin lymphoma that was found to be expressed in 17/20 cases (85%) of classical Hodgkin lymphoma but none of 27 cases of primary mediastinal large B cell lymphoma in a recent study by Salama et al 18 That study also found that CD23, one of the immunophenotypic markers useful for distinguishing primary mediastinal large B cell lymphoma from diffuse large B cell lymphoma, was expressed in 23/27 cases (85%) of primary mediastinal large B cell lymphoma but only 2/18 cases (11%) of classical Hodgkin lymphoma, in rare, scattered Reed-Sternberg cells. 18 MAL, another primary mediastinal large B cell lymphoma marker, was found to be expressed in only 3/31 cases of classical Hodgkin lymphoma, 10 so it too may be useful for this application. In contrast, TRAF and REL fail to distinguish primary mediastinal large B cell lymphoma from classical Hodgkin lymphoma: 21/25 cases (84%) of classical Hodgkin lymphoma were found to be immunoreactive for TRAF and 23/25 cases (92%) were immunoreactive for REL.…”

Primary mediastinal B-cell lymphoma and mediastinal gray zone lymphoma: do they require a unique therapeutic approach?

“…[3][4][5] The germinal center markers CD10, BCL6, and CD23 are expressed in most cases of PMBL, in keeping with its thymic B-cell origin. 6,7 Distinguishing PMBL from NSHL can sometimes be challenging for the pathologist: NSHL has a nodular pattern of growth, as well as the presence of lacunar variants of Hodgkin/Reed-Sternberg cells with a characteristic immunophenotype. In contrast to PMBL, cells are typically CD15-positive and are strongly positive for CD30.…”

Mediastinal mass in clinical practice

“…Одним из рекомендуемых режимов является DA-EPOCH-R без лучевой терапии [16]. Именно такой режим химиотерапии был начат пациентке.…”

“…Именно такой режим химиотерапии был начат пациентке. Добавление ритуксимаба к основному режиму улучшает ответ, выживаемость и уменьшает риск прогрессии забо-левания [16].…”