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progressive transformation of germinal centers

Monday 15 December 2003

Definition: Progressive transformation of the germinal centers (PTGC) was initially reported by Lennert & Müller-Hermelink.

PTGC are larger than regular germinal centers and are mainly composed of mantle zone lymphocytes and remnants of large germinal center cells.

The mantle zone is obscured, and the interfollicular areas usually contain small lymphocytes and a few immunoblasts. PTGC are usually found in the lymph nodes of patients with reactive follicular hyperplasia.

An association between PTGC and nodular lymphocyte predominant Hodgkin lymphoma has been described.

Images

 Progressive transformation of germinal centers (PTGC)

Synopsis

 Progressive transformation of germinal centers (PTGC) is a reactive lymph node pattern.
 Enlarged lymphoid nodules with invagination of the mantle zone into the germinal center.
 Background of reactive follicular hyperplasia.
 Can be associated with NLP Hodgkin Lymphoma.

Digital case

 HPC:209 : Progressive transformation of germinal centers
 HPC:350 : Progressive transformation of germinal centers

Variants

 focal progressive transformation of germinal centers (focal PTGC)
 florid progressive transformation of germinal centers (florid PTGC) (1599017)

Association

 classical Hodgkin lymphoma (2405631, 14533939)
 nodular lymphocyte-predominant Hodgkin lymphoma (43015, 6496841, 2405631, 1574490)

Differential diagnosis

 follicular lymphoma (3307374)
 nodular lymphocyte-predominant Hodgkin lymphoma (6369997, 14533939, 9888701)
 hyaline-vascular type of Castleman’s disease (15865611)

References

 Lin P, Medeiros LJ, Wilder RB, Abruzzo LV, Manning JT, Jones D. The activation profile of tumour-associated reactive T-cells differs in the nodular and diffuse patterns of lymphocyte predominant Hodgkin’s disease. Histopathology. 2004 Jun;44(6):561-9. PMID: 15186271

 Kojima M, Nakamura S, Shimizu K, Tanaka H, Yamane Y, Sugihara S, Masawa N. Classical Hodgkin lymphoma occurring in clusters of nodal marginal zone B-lymphocytes in association with progressive transformation of germinal center. A case report. Pathol Res Pract. 2003;199(8):547-50. PMID: 14533939

 Chang CC, Osipov V, Wheaton S, Tripp S, Perkins SL. Follicular hyperplasia, follicular lysis, and progressive transformation of germinal centers. A sequential spectrum of morphologic evolution in lymphoid hyperplasia. Am J Clin Pathol. 2003 Sep;120(3):322-6. PMID: 14502795

 Kojima M, Nakamura S, Shimizu K, Tanaka H, Yamane Y, Sugihara S, Masawa N. Classical Hodgkin lymphoma occurring in clusters of nodal marginal zone B-lymphocytes in association with progressive transformation of germinal center. A case report. Pathol Res Pract. 2003;199(8):547-50. PMID: 14533939

 Kojima M, Nakamura S, Motoori T, Itoh H, Shimizu K, Yamane N, Ohno Y, Ban S, Yoshida K, Hoshi K, Oyama T, Shimano S, Sugihara S, Sakata N, Masawa N. Progressive transformation of germinal centers: a clinicopathological study of 42 Japanese patients. Int J Surg Pathol. 2003 Apr;11(2):101-7. PMID: 12754626

 Jones D. Dismantling the germinal center: comparing the processes of transformation, regression, and fragmentation of the lymphoid follicle. Adv Anat Pathol. 2002 Mar;9(2):129-38. PMID: 11917166

 Nguyen PL, Ferry JA, Harris NL. Progressive transformation of germinal centers and nodular lymphocyte predominance Hodgkin’s disease: a comparative immunohistochemical study. Am J Surg Pathol. 1999 Jan;23(1):27-33. PMID: 9888701

 Ferry JA, Zukerberg LR, Harris NL. Florid progressive transformation of germinal centers. A syndrome affecting young men, without early progression to nodular lymphocyte predominance Hodgkin’s disease. Am J Surg Pathol. 1992 Mar;16(3):252-8. PMID: 1599017

 Osborne BM, Butler JJ, Gresik MV. Progressive transformation of germinal centers: comparison of 23 pediatric patients to the adult population. Mod Pathol. 1992 Mar;5(2):135-40. PMID: 1574490

 Osborne BM, Butler JJ, Gresik MV. Progressive transformation of germinal centers: comparison of 23 pediatric patients to the adult population. Mod Pathol. 1992 Mar;5(2):135-40. PMID: 1574490

 Hansmann ML, Fellbaum C, Hui PK, Moubayed P. Progressive transformation of germinal centers with and without association to Hodgkin’s disease. Am J Clin Pathol. 1990 Feb;93(2):219-26. PMID: 2405631

 Osborne BM, Butler JJ. Clinical implications of progressive transformation of germinal centers. Am J Surg Pathol. 1984 Oct;8(10):725-33. PMID: 6496841

 Burns BF, Colby TV, Dorfman RF. Differential diagnostic features of nodular L & H Hodgkin’s disease, including progressive transformation of germinal centers. Am J Surg Pathol. 1984 Apr;8(4):253-61. PMID: 6369997

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