“Clarification needed ”
Is this biopsy complete negative for cancer or does the comment section positive CD30 indicate something otherwise? March 2021 lost voice s/p Covid vaccine, 5 days later SOB and chest Pain. Symptoms continued. Was treated for asthma PFT ruled that out. Was treated for gerd w/no relief. Saw ENT slight deviated septum and blocked sinuses. Balloon sinuplasty to be done. Most recent pain in clavicular region. CT scan showed b/l lymphoid hyperplasia at the base of tongue and nasophArynx
DIAGNOSIS:
1. Nasopharynx Biopsy:
- Respiratory mucosa and reactive lymphoid hyperplasia, negative for carcinoma, see note
Note: Immunohistochemical stain for pancytokeratin is negative for carcinoma.
2. Base of Tongue Biopsy:
- Tonsillar tissue and reactive lymphoid hyperplasia, negative for carcinoma, see note
COMMENT:
Immunohistochemical stain for p16 is negative. A deeper level has been examined. Case was also reviewed by Dr. (Surgical Pathology service).
Sections show mucosa with dense lymphoid proliferation. Multiple reactive follicles are noted. Immunostains were performed on part 1. CD20 shows B-cell follicles. BCL-6 highlights the germinal centers that are negative for BCL-2 but with expectedly high Ki- 67 proliferation index (90%). IGD stains mantle cells. CD23 shows FDC meshworks. CD3 and CD5 stain T cells. B-cells are negative for CD5. OCT2 stains B cells and highlights some immunoblasts which are also positive for CD30. EBER is negative. Kappa and lambda stain polytypic plasma cells.
DIAGNOSIS:
1. Nasopharynx Biopsy:
- Respiratory mucosa and reactive lymphoid hyperplasia, negative for carcinoma, see note
Note: Immunohistochemical stain for pancytokeratin is negative for carcinoma.
2. Base of Tongue Biopsy:
- Tonsillar tissue and reactive lymphoid hyperplasia, negative for carcinoma, see note
COMMENT:
Immunohistochemical stain for p16 is negative. A deeper level has been examined. Case was also reviewed by Dr. (Surgical Pathology service).
Sections show mucosa with dense lymphoid proliferation. Multiple reactive follicles are noted. Immunostains were performed on part 1. CD20 shows B-cell follicles. BCL-6 highlights the germinal centers that are negative for BCL-2 but with expectedly high Ki- 67 proliferation index (90%). IGD stains mantle cells. CD23 shows FDC meshworks. CD3 and CD5 stain T cells. B-cells are negative for CD5. OCT2 stains B cells and highlights some immunoblasts which are also positive for CD30. EBER is negative. Kappa and lambda stain polytypic plasma cells.
Female | 42 years old
Complaint duration: 03/03/2021
Medications: None
Conditions: MTHFR, Factor V Leiden
2 Answers
This biopsy implies that there is no evidence of cancer in the specimen. This combined with whatever is found in the physical exam, the imaging, and patient history would lead to the overall diagnosis. The biopsy alone cannot be used to make the determination that there is no tumor, it is part of the supporting data to a diagnosis.
Hello,
You are asking about the specificity of CD30 in tissue obtained from a biopsy. The reports that your question includes suggest that an intensive investigation using multiple stains has been performed and that an opinion was obtained from a second pathologist.
CD30 positivity has been reported in lymphomas, Hodgkins Disease and also non-Hodgkins lymphomas. However it can also be positive in benign skin conditions. Your doctor seems to have done an intensive investigation.
The symptoms started in March, 2021. Lymphomas would usually spread to other lymph node groups in a year and a half. My thought would be that these findings indicate a reactive process. If you should have nodal swelling, another biopsy should be obtained.
Good luck.
You are asking about the specificity of CD30 in tissue obtained from a biopsy. The reports that your question includes suggest that an intensive investigation using multiple stains has been performed and that an opinion was obtained from a second pathologist.
CD30 positivity has been reported in lymphomas, Hodgkins Disease and also non-Hodgkins lymphomas. However it can also be positive in benign skin conditions. Your doctor seems to have done an intensive investigation.
The symptoms started in March, 2021. Lymphomas would usually spread to other lymph node groups in a year and a half. My thought would be that these findings indicate a reactive process. If you should have nodal swelling, another biopsy should be obtained.
Good luck.
