Progressive transformation of germinal centres

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Progressive transformation of germinal centres, abbreviated PTGCs and also progressive transformation of germinal centers, is a reactive lymph node process of undetermined etiology.

Symptoms

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

Diagnosis

File:Progressive transformation of germinal centres -1- low mag.jpg
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

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