Differential diagnosis between T cell rich, large B cell lymphoma (TCRBCL), lymphocyte predominant Hodgkin's lymphoma (LP-HL), and common Hodgkin's lymphoma (CHL)
| Diagnostic criteria | TCRBCL | LP-HL Nodular/diffuse | CHL |
|---|---|---|---|
| EMA, epithelial membrane antigen; FDC, follicular dendritic cells; L/H, lymphocytic/histiocytic (popcorn); RS, Reed Sternberg. | |||
| *Weakly positive in some instances; †negative in rare instances; ‡usually overexpressed; §in 1–2% of the cases T cell receptor gene rearrangement. | |||
| Neoplastic component | |||
| Cell distribution | Dispersed | Within the nodules | Dispersed |
| L&H/L&H-like cells | −/+ | +/− | − |
| RS/RS-like cells | −/+ | −/+ | − |
| CD45 expression | + | + | − |
| CD30 expression | −* | −* | + |
| CD15 expression | − | − | +/− |
| CD79a expression | +/− | −/+ | −/+ Variable |
| CD20 expression | +† | +† | −/+ Variable |
| BOB.1 expression | + | + | − |
| Oct2 expression | +‡ | +‡ | Rare |
| CD3 expression | − | − | −/+ |
| EMA expression | +/− | +/− | Rare |
| J chain expression | +/− | +/− | − |
| MIB-1/Ki-67 expression | High | High | High |
| EBV | − | − | + Variable |
| Ig gene rearrangement | + | + | +§ |
| Reactive component | |||
| T cells | Numerous | Moderate | Variable |
| T cells with irregular nuclear profile | +/− | − | −/+ |
| Bcl-6+/CD57+ rosettes | − | Numerous | − |
| Amount of TIA-1+ cells | Very high | Low | High |
| Amount of CD20+ small lymphocytes | Low | High | Low |
| Histiocytes | Variable | Some | Variable |
| FDC | − | + | + |
| Clinical findings | |||
| Stage | III/IV | I/II | I/III |
| Bone marrow involvement | +/− | − | − |
| Orderly progression in the spread | − | − | + |