β-HCG aberrant expression in primary mediastinal large B-cell lymphoma

Giulio Fraternali-Orcioni, Brunangelo Falini, Federico Quaini, Elias Campo, Milena Piccioli, Barbara Gamberi, Gianandrea Pasquinelli, Simonetta Poggi, Stefano Ascani, Elena Sabattini, Stefano A. Pileri

Research output: Contribution to journalArticle

Abstract

We report on a primary mediastinal large B-cell lymphoma with aberrant expression of β-human chorionic gonadotropin (β-hCG). The patient, a 33- year-old man, had cough, dyspnea, fever, superior vena cava syndrome, and a mediastinal bulky tumor. A biopsy showed that the latter was characterized by large cells, sclerosis, and compartmentalization. The neoplastic elements expressed CD45, CD20, CD79a and, partially, CD30, whereas they were negative for CD3, epithelial membrane antigen and cytokeratins. Surprisingly, they displayed a clear-cut positivity for β-hCG. The remaining oncofetal markers applied (PLAP and α1-fetoprotein) were negative. Electron microscopy demonstrated the presence of numerous nuclear pockets and the lack of intercellular junctions. DNA analysis by polymerase chain reaction showed clonal rearrangement of Ig heavy-chain genes. The patient responded promptly to the administration of MACOP-B. To the best of our knowledge, this is the first example of B-cell lymphoma showing positivity for β-hCG; a similar aberrant expression was previously observed only in three Japanese patients with human T-cell lymphotropic virus type I+ adult T-cell lymphoma/leukemia. Because primary mediastinal large B-cell lymphoma has in the past been frequently confused with germ cell tumors, pathologists should be aware of possible β-hCG expression by lymphomatous cells to avoid the risk of misdiagnosis.

Original languageEnglish
Pages (from-to)717-721
Number of pages5
JournalAmerican Journal of Surgical Pathology
Volume23
Issue number6
DOIs
Publication statusPublished - Jun 1999

Keywords

  • β-hCG
  • Electron microscopy
  • Immunohistochemistry
  • Malignant lymphoma
  • Mediastinum
  • Molecular biology

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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    Fraternali-Orcioni, G., Falini, B., Quaini, F., Campo, E., Piccioli, M., Gamberi, B., Pasquinelli, G., Poggi, S., Ascani, S., Sabattini, E., & Pileri, S. A. (1999). β-HCG aberrant expression in primary mediastinal large B-cell lymphoma. American Journal of Surgical Pathology, 23(6), 717-721. https://doi.org/10.1097/00000478-199906000-00012