Table 3

Differential diagnosis between anaplastic large cell lymphoma Hodglin's-like (ALCL-HL) and classic Hodgkin's lymphoma (HL)

ALCL-HLHL
*The intensity of immunostaining may vary within the same case; †results can vary depending on the fixative used; ‡membrane bound and/or dot-like positivity; §some cases with morphology and phenotypic profile consistent with ALCL-HL (including BSAP negativity) can lack t(2;5)/ALK protein expression: these cases need further studies to assess their definitive inclusion among anaplastic large cell lymphomas; ¶in 1–2% of the cases T cell receptor gene rearrangement occurs.
EBV, Epstein-Barr virus; EMA, epithelial membrane antigen; TCR, T cell receptor.
Morphological characteristics
Neoplastic componentUsually cohesiveUsually dispersed
Reactive componentOften minorUsually prevalent
Reed-Sternberg cellsMay be presentAlways present
Intrasinusoidal diffusionTypicalExceptional
Molecular characteristics
CD30++*
CD45+/−
CD15−/++/−
EMA+/−rare
CBF.78+ (80–90%)−/+ (rare cells)
BHN.9+ (60%)†− (5%)
CD3−/+‡10%
T cell rosettes+/−
p53−/++
EBV−/++ or +/−
Clonal TCR gene rearrangement+
Clonal Ig gene rearrangement+
PAX-5 gene product/BSAP+
t(2;5)/ALK protein