Mahmoud Wahied Emara, Masood Mohamed Omar, Kamal Ahmad Mostafa, Abdel Fatah M.Abdel Fatah


Background: Lymphoid proliferations are thought to be either benign reactive conditions, atypical lymphoid proliferations or malignant lymphomas. NHL's are a diverse group of malignant neoplasms that affect lymphoid tissue, their incidence has risen twofold over the past 10 years. IHC, is now routinely used to confirm the diagnosis of lymphoma.
The aim: Is to evaluate the expression of Survivin, P63 and CD15 in different types of reactive lymphoid hyperplasia and lymphoma and their ability to differentiate between some types of them. Also, correlate expression of the above markers as indicators of aggressiveness in NHL's.
Methods: A total of selected 80 cases of patients which were previously diagnosed as: 30 cases of Non Hodgkin's lymphoma, 20 cases of Hodgkin's lymphoma, and 30 cases of reactive lymphoid hyperplasia. The sections were stained with H&E and immunohistochemical markers of Survivin, p63 and CD15 separately.
Results: Expression of survivin & P63 immunostains in cases of aggressive lymphomas was (61.9%)&(71.4%) which are higher than their expression in cases of indolent lymphomas (38.1%)&(28.6%) respectively. Also, expression of survivin &P63 immunostains in cases of follicular lymphoma was (50%)&(33.3%) which are higher than their expression in cases of atypical lymphoid hyperplasia(40%)&(20%) respectively. P63 was frequently expressed in large cell lymphoma cases (64.2%). None of the cases of CHL demonstrated any P63 expression. CD15 is a specific marker of reed Sternberg cells of CHL and showed no expression in cases of lymphocytic predominance HL. CD15 was also occasionally expressed in cases of large cell lymphomas.
Conclusion: survivin and P63markers can be used as immunohistochemical tools in distinguishing follicular lymphoma from lymphoid hyperplasia especially atypical cases. Also, survivin and P63markers can be used as indicator of aggressiveness in NHL cases. CD15 is a specific marker of RS cells of CHL. Also, CD15 is occasionally expressed in cases of large cell lymphomas, so not used alone in differentiation between large cell lymphoma and CHL where morphological distinction is difficult. When adding a P63 immunostaining, the accuracy of distinction between these lesions was increased. so,P63 can be used as a potential tool in the differential diagnosis between these lesions.
Key words, IHC, CHL, RS cells, NLPHL, Survivin, P63, Immunohistochemistry.

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