Progressive transformation of germinal centres

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

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.

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.

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.

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.^[2]^[3]

^ 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.
^ Hansmann ML, Fellbaum C, Hui PK, Moubayed P (February 1990). "Progressive transformation of germinal centers with and without association to Hodgkin's disease". American Journal of Clinical Pathology. 93 (2): 219–26. PMID 2405631.
^ 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.