Progressive transformation of germinal centres

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| name = Progressive transformation of germinal centres

| synonyms = progressive transformation of germinal centers

| image = Progressive transformation of germinal centres -1- very low mag.jpg

| caption = Micrograph of a lymph node biopsy showing progressive transformation of germinal centres. H&E stain.

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| field = Infectious disease

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

Signs and symptoms

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

Diagnosis

Image:Progressive transformation of germinal centres -1- low mag.jpg 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:{{cite journal |vauthors=Verma A, Stock W, Norohna S, Shah R, Bradlow B, Platanias LC |title=Progressive transformation of germinal centers. Report of 2 cases and review of the literature |journal=Acta Haematol. |volume=108 |issue=1 |pages=33–8 |year=2002 |pmid=12145465 |doi= 10.1159/000063057}}

  • 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 a small proportion of patients have been reported to subsequently develop nodular lymphocyte predominant Hodgkin lymphoma.{{cite journal |vauthors=Hansmann ML, Fellbaum C, Hui PK, Moubayed P |title=Progressive transformation of germinal centers with and without association to Hodgkin's disease |journal=American Journal of Clinical Pathology |volume=93 |issue=2 |pages=219–26 |date=February 1990 |pmid=2405631 }}{{cite journal |vauthors=Kojima M, Nakamura S, Motoori T, etal |title=Progressive transformation of germinal centers: a clinicopathological study of 42 Japanese patients |journal=Int. J. Surg. Pathol. |volume=11 |issue=2 |pages=101–7 |date=April 2003 |pmid=12754626 |doi= 10.1177/106689690301100205}}

See also

References

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