Immunodeficiency-related lymphoproliferative disorders (ID-LPDs): polymorphic and Hodgkin lymphoma-like
| S/no. | Diagnostic points and pitfalls |
|---|---|
| 1. | Polymorphic ID-LPDs often show effacement of architecture but do not meet diagnostic criteria for standard lymphoma subtypes. |
| 2. | In the non-transplant context (eg, patients with rheumatoid arthritis receiving methotrexate), the presence/significance of immunosuppression may not be clinically recognised and a detailed history not provided. |
| 3. | Occurrence of CD30 and EBV positivity in the large cells without recognising the presence of concurrent positive small-to-medium-sized cells may mislead the pathologist to diagnose a polymorphic PTLD as CHL. |
| 4. | Anti-CD20 therapy may have been previously given to patients with suspected PTLD. Loss of CD20 positivity should be closely correlated with such history and other B-cell markers and cannot in isolation be assumed to represent genuine absence of a B cell phenotype. |
CHL, classical Hodgkin lymphoma; EBV, Epstein-Barr virus; PTLD, post-transplant lymphoproliferative disorders.