Progressive transformation of germinal centres explained

Progressive transformation of germinal centres
Synonyms:	progressive transformation of germinal centers
Field:	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.

Diagnosis

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 a small proportion of patients have been reported to subsequently develop nodular lymphocyte predominant Hodgkin lymphoma.^{[2] [3]}

See also

• Lymphadenopathy
• Nodular lymphocyte predominant Hodgkin lymphoma

Notes and References

1. Verma A, Stock W, Norohna S, Shah R, Bradlow B, Platanias LC . Progressive transformation of germinal centers. Report of 2 cases and review of the literature . Acta Haematol. . 108 . 1 . 33–8 . 2002 . 12145465 . 10.1159/000063057.
2. Hansmann ML, Fellbaum C, Hui PK, Moubayed P . Progressive transformation of germinal centers with and without association to Hodgkin's disease . . 93 . 2 . 219–26 . February 1990 . 2405631 .
3. Kojima M, Nakamura S, Motoori T, etal . Progressive transformation of germinal centers: a clinicopathological study of 42 Japanese patients . Int. J. Surg. Pathol. . 11 . 2 . 101–7 . April 2003 . 12754626 . 10.1177/106689690301100205.