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Immunohistochemical, enzyme histochemical, and immunologic features of giant lymph node hyperplasia of the hyaline‐vascular type
Author(s) -
Carbone Antonino,
Manconi Riccardo,
Volpe Rachele,
Poletti Alessandro,
De Paoli Paolo,
Santini Gianfranco,
Tirelli Umberto
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860815)58:4<908::aid-cncr2820580418>3.0.co;2-1
Subject(s) - medicine , pathology , immunohistochemistry , hyaline , lymph node , hyperplasia
A combined histologic, immunohistologic, enzyme histochemical, and immunologic study has been carried out in a 7‐year‐old girl with recurring extramediastinal monocentric giant lymph node hyperplasia of hyaline‐vascular type. A large panel of monoclonal and polyclonal antibodies to lymphoid and nonlymphoid cell markers were tested on frozen and paraffin‐embedded lymph node tissue as well as on cell suspension and peripheral blood. Tissue enzyme histochemical study, including a conventional hematologic panel, was performed on frozen and plastic‐embedded sections. The pattern was dominated by nodular aggregates of round BA‐1+ Leu‐14+ HLA‐DR+ ATPase+ lymphocytes with polyclonal sIgD and sIgM positivity and lacking clg and BA‐2 staining. Leu‐l+/Leu‐4+, OKT6+, OKT10+, Leu‐7+, and CALLA+ cells were few or absent in the nodules, whereas DRC‐1+ BA‐2+ HLA‐DR+ 5′‐Nuc+ cells formed a dendritic network in the outer portion of the nodules. No immunoreactivity for lymphoid and nonlymphoid cell markers, including cytokeratin and keratin, was detected in centrinodular histiocytic‐like cells. Particularly, the Hassall's‐like structures contained a target‐like positivity for laminin, and consisted of flattened acid phosphatase (AP), alpha‐naphthyl acetate esterase (ANAE), 5′‐nucIeotidase (5′‐Nuc), and adenosine tri‐phosphatase (ATPase) positive cells, whose enzyme profile overlapped with that of the histiocytic‐like cells. The extranodular areas were mainly composed of Leu‐1+/Leu‐4+ lymphocytes with Leu‐3a+/ OKT4+ phenotype and, to a lesser extent, of OKT6+ OKT10+ lymphoid cells and scattered cells with markers of histiocytic lineage. The abundant vascular component was generally identified by laminin positivity and, in smaller proportion, it was positive for Factor VIII‐related antigen. Most of the medium‐sized vessels with high endothelium had marked AP, ANAE, and ATPase activities. The process observed resulted from vascularized nodular aggregates of nontransformed B‐cells with the phenotype of primary follicle lymphocytes, associated to centrinodular histiocytic‐like cells with a distinct enzyme profile.