Differential diagnosis between classic Hodgkin's lymphoma, T-cell-rich B-cell lymphoma, and paragranuloma by paraffin immunohistochemistry

Am J Surg Pathol. 1998 Oct;22(10):1184-91. doi: 10.1097/00000478-199810000-00003.


There are significant difficulties in the differential diagnosis of lymphomas at the interface between classic Hodgkin's lymphoma and both paragranuloma and T-cell-rich B-cell lymphoma as well as at the interface between T-cell-rich B-cell lymphoma and paragranuloma. We therefore investigated 197 cases (155 classic Hodgkin's lymphomas, 32 T-cell-rich B-cell lymphomas, and 10 paragranulomas) by paraffin immunohistochemistry. Special interest was given to cases with a B-cell phenotype of tumor cells. The reactive inflammatory infiltrate in both classic Hodgkin's lymphoma and T-cell-rich B-cell lymphoma was rich in TIA-1-positive cytolytic lymphocytes, and CD57-positive cells were rarely encountered. In contrast, in paragranuloma CD57-positive cells and small B-lymphocytes predominated the background infiltrate. The tumor cells in cases of classic Hodgkin's lymphoma were positive for CD30 in 95%, for CD15 in 75%, and for CD20 in 22%. Apart from this, vimentin was expressed in >95% of the cases. All cases of T-cell-rich B-cell lymphoma were negative for vimentin, CD30, and CD15. The reactivity of the tumor cells for CD30, CD15, CD20, and vimentin together with the background reactivity for CD57 and TIA-1 seem to reliably discriminate between the entities and should therefore help to increase the interobserver reproducibility of diagnoses in the gray zone around Hodgkin's lymphoma.

Publication types

  • Review

MeSH terms

  • Antigens, CD20 / metabolism
  • CD57 Antigens / metabolism
  • Diagnosis, Differential
  • Hodgkin Disease / diagnosis*
  • Hodgkin Disease / metabolism
  • Hodgkin Disease / pathology
  • Humans
  • Immunoenzyme Techniques
  • Lymphoma, B-Cell / diagnosis*
  • Lymphoma, B-Cell / metabolism
  • Lymphoma, B-Cell / pathology
  • Membrane Proteins / metabolism
  • Paraffin Embedding
  • Poly(A)-Binding Proteins
  • Proteins*
  • RNA-Binding Proteins / metabolism
  • Retrospective Studies
  • T-Cell Intracellular Antigen-1
  • T-Lymphocytes / pathology*
  • Vimentin / metabolism


  • Antigens, CD20
  • CD57 Antigens
  • Membrane Proteins
  • Poly(A)-Binding Proteins
  • Proteins
  • RNA-Binding Proteins
  • T-Cell Intracellular Antigen-1
  • TIA1 protein, human
  • Vimentin