Background Although IgG4-related disease has been gradually recognized, its relationship with malignant diseases, especially lymphoma has been an eternal topic.
Objectives To explore the expression of IgG4 positive cells in lymphoma.
Methods Surgical excision specimens with definite diagnosis of lymphoma from January to December, 2013 were collected. Hematoxylin-eosin staining and immunohistochemical staining of IgG and IgG4 were then evaluated on dense lymphoplasmacytic infiltration, storiform fibrosis and obliterative phlebitis. For the quantification of IgG and IgG4 positive cells, the areas with the highest density of positive cells were evaluated. Three high-powered fields (hpf) in each section were analyzed, and the average number of positive cells per hpf was calculated.
Results 16 patients with lymphoma were selected in our study. There were 9 males and 7 females with an average age of 51 years old. The pathologic type included 13 cases of non-Hodgkin lymphoma and 3 cases of Hodgkin lymphoma. Sub types of Non-Hodgkin lymphoma contained 8 cases of diffuse large B cell lymphoma, 2 cases of small B cell lymphoma, 1 case of mucosa accociated lymphoid tissue marginal zone B cell lymphoma (MALToma), follicular lymphoma, peripheral T-cell lymphoma and hepatosplenic T-cell lymphoma. The 16 specimens all manifested as dense lymphocytic infiltration, accompanied by atypical lymphocytes. Proliferation of fibrous tissue was only seen in one specimen. 14 cases were IgG positive with the highest cell count from 20–350/hpf. IgG can be expressed in both cytoplasm and cytomembrane. 2 cases of IgG4 positive were Hodgkin lymphoma and the highest cell counts were 11 and 12/hpf respectively.
Conclusions IgG4 positive cell, fibrosis and obliterative phlebitis seldom appear in lymphoma. Added specific tumor signature molecules, it may not be difficult to distinguish lymphoma from IgG4-related disease.
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Disclosure of Interest None declared