Progressive transformation of germinal centres

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.

Diagnosis

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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:

• 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).

See also

• Lymphadenopathy
• Nodular lymphocyte predominant Hodgkin lymphoma

External links

Classification