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American Journal of Pathology, Vol 139, 1281-1289, Copyright © 1991 by American Society for Investigative Pathology

REGULAR ARTICLES

L and H cells of nodular lymphocyte predominant Hodgkin's disease show immunoglobulin light-chain restriction

C Schmid, C Sargent and PG Isaacson
Department of Histopathology, University College and Middlesex School of Medicine, London, United Kingdom.

The nodular form of lymphocyte predominant Hodgkin's disease (NLPHD) is widely accepted to be a B-cell-derived neoplasm. Despite this consensus, previous studies have not shown monotypic immunoglobulin (Ig) light-chain expression by the putatively malignant L & H cells. We have studied paraffin-embedded tissue from 19 cases of NLPHD for the presence of Ig light and heavy chains and J chain. In addition, frozen tissue, available from one case, was examined with antibodies to light chains. In paraffin material, in each case L & H cells in individual nodules were examined for the presence of Ig light chain restriction. Kappa-light-chain restriction was detected in all L & H cells in all nodules in 5/19 cases (26.5%) and this was confirmed in frozen sections available from one case. Of the remaining 14 cases, 13 (68.5%) showed kappa-light-chain restriction in a proportion of nodules and in 1 case light-chain restriction was not observed. Of 14 cases stained with antibodies to Ig heavy chains 13 contained IgG, and in 1 case no heavy chains were demonstrable. Most L & H cells in 15 cases examined contained J chain. Our finding of monotypic L & H cells in NLPHD in 95% of our investigated cases provides strong evidence for the neoplastic nature of L & H cells and supports the hypothesis that NLPHD is a malignant nonHodgkin's B-cell lymphoma.

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