Progressive Transformation of Germinal Centers

Abstract

Progressive transformation of germinal centers (PTGC) is a disease of mostly young adults that presents as unexplained, asymptomatic, localized or generalized lymphadenopathy which is usually persistent or recurrent over periods of many years. Histologically, the germinal centers contain a variable proportion of small mantle zone lymphocytes and thus become progressively transformed and may result in the loss of clear demarcation between them and the mantle zone. Here, we describe two cases of this disease and review the literature on the association of PTGC with lymphocyte-predominant Hodgkin’s disease.

Progressive Transformation of Germinal Centers (PTGC) in the Head and Neck

“…The absence of Reed-Sternberg cell and lymphohistiocytic (LH) cells also differentiates PTGC from NLPHD. LH cells in NLPHD have multilobulated nuclei with fine chromatin and small nucleoli [6,9]. Partial involvement of the node with PTGC is also useful for differentiation from NLPHD that demonstrates near complete replacement of normal nodal architecture [11].…”

Non-infectious unilateral cervical lymphadenopathy in children - a case report

“…Najčešće je riječ o uvećanom cervikalnom limfnom čvoru, a druge česte lokalizacije su ingvinalna i aksilarna regija (14,15). Etiopatogeneza entiteta još je nerazjašnjena (16).…”

“…Stanje je karakterizirano rekurentnim tijekom, te se u dijagnostičko-terapijske svrhe provode mulitple ekstirpacije i biopsije uvećanih limfnih čvorova (13). histološki je uočljiva folikularna hiperplazija te gubitak jasne granice između germinalnih centara i mantle zone, budući da sitni limfociti iz mantle zone progresivno ulaze u germinativne centre i ekspandiraju ih (13,16). Riječ je o benignoj bolesti sa povoljnom prognozom, ali nužno je redovito praćenje zbog odluke o ekstirpaciji i pravovremenog otkrivanja mogućih komorbiditeta (13).…”

Progressive Transformation of Germinal Centers Simulating Malignant Axillary Lymphadenopathy in a Breast Cancer Patient on FDG PET/CT

“…The microscopic and immunohistochemical findings were characteristic of progressive transformation of germinal centers. This is an uncommonly diagnosed benign disease of lymph nodes that manifests as nontender chronic lymphadenopathy usually involving the cervical and axillary areas, and it is not considered a premalignant condition [1][2][3]. Imaging findings of progressive transformation of germinal centers are rarely reported in very few studies [4][5][6].…”

“…This is an uncommonly diagnosed benign disease of lymph nodes that manifests as nontender chronic lymphadenopathy usually involving the cervical and axillary areas, and it is not considered a premalignant condition. [1][2][3] Imaging findings of progressive transformation of germinal centers are rarely reported in very few studies. [4][5][6] Although the reported incidence of contralateral axillary lymph node metastases in breast cancer is only 6%, 7,8 the imaging findings in our case including FDG-avid enlarged lymph nodes with loss of normal architecture were worrisome for malignancy, either metastases or a possibility of second primary tumor such as lymphoma.…”