Progressive transformation of germinal centres

Progressive transformation of germinal centres (PTGCs) is a reactive lymph node process of undetermined cause.

Progressive transformation of germinal centres
Other namesprogressive transformation of germinal centers
Micrograph of a lymph node biopsy showing progressive transformation of germinal centres. H&E stain.
SpecialtyInfectious disease

Signs and symptoms

PTGC is usually characterized by localized lymphadenopathy and is otherwise typically asymptomatic.

Diagnosis
Micrograph showing PTGCs. H&E stain.

PTGC is diagnosed by surgical excision of the affected lymph node(s), and examination by a pathologist. The differential diagnosis includes non-neoplastic causes of lymphadenopathy (e.g. cat-scratch fever, Kikuchi disease) and malignancy, i.e. cancer.

Microscopic appearance

PTGCs is characterized by:[1]

  • follicular hyperplasia (many follicles),
  • focally large germinal centres, with poorly demarcated germinal centre (GC)/mantle zone interfaces (as GCs infiltrated by mantle zone lymphocytes), and
  • an expanded mantle zone.

Treatment

PTGC is treated by excisional biopsy and follow-up. It may occasionally recur and in a small proportion of patients has been reported to subsequently develop Hodgkin lymphoma (usually nodular lymphocyte predominant Hodgkin lymphoma).[2][3]

See also

References
  1. Verma A, Stock W, Norohna S, Shah R, Bradlow B, Platanias LC (2002). "Progressive transformation of germinal centers. Report of 2 cases and review of the literature". Acta Haematol. 108 (1): 33–8. doi:10.1159/000063057. PMID 12145465.
  2. Hansmann ML, Fellbaum C, Hui PK, Moubayed P (February 1990). "Progressive transformation of germinal centers with and without association to Hodgkin's disease". Am. J. Clin. Pathol. 93 (2): 219–26. PMID 2405631.
  3. Kojima M, Nakamura S, Motoori T, et al. (April 2003). "Progressive transformation of germinal centers: a clinicopathological study of 42 Japanese patients". Int. J. Surg. Pathol. 11 (2): 101–7. doi:10.1177/106689690301100205. PMID 12754626.
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