NCCN Guidelines® on CD30 testing in lymphoma*

The NCCN Guidelines recommend CD30 testing for the differential diagnosis of Hodgkin and certain non-Hodgkin lymphomas.1,2

CD30 testing is recommended for the diagnosis of the following lymphomas:

  • Anaplastic large cell lymphoma (ALCL), anaplastic lymphoma kinase (ALK)–positive2
  • ALCL, ALK-negative2
  • Angioimmunoblastic T-cell lymphoma (AITL)2
  • Enteropathy-associated T-cell lymphoma (EATL)2
  • Hodgkin lymphoma1
  • Mycosis fungoides/Sézary syndrome when large cell transformation is observed2
  • Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS)2

CD30 testing is useful under certain circumstances in the following lymphomas:

  • Diffuse large B-cell lymphoma (DLBCL)2
  • Mycosis fungoides/Sézary syndrome2
  • Post-transplant lymphoproliferative disorders2

Antibody panels directed toward multiple antigens can aid diagnostic decisions by complementing morphologic findings and clinical characteristics.3 For example, although Hodgkin lymphoma cells are characterized by the distinct morphology of the Reed-Sternberg cell, the NCCN Guidelines recommend a panel of antigens, including CD30, in the diagnosis of Hodgkin lymphoma.1

Sample Hodgkin lymphoma IHC panel3

Antigen Reactivity in normal lymphoid tissues Findings in RS cells in cHL
PAX 5B cells Most cases (≈90%) positive
CD20B cells Sometimes positive in a subset
CD3T cells, NK cells Negative
CD15Granulocytes, some histiocytes, epithelial cells and carcinomas, CMV-infected cells Most cases (≈85%) positive
CD30Activated lymphoid cells Positive
LCALeukocytes Negative
ALKNone Negative
RS = Reed-Sternberg; cHL = classical Hodgkin lymphoma; CMV = cytomegalovirus; LCA = leukocyte common antigen

CD30 IHC complements morphologic findings in classical Hodgkin lymphoma

H&E stain

H&E stain

CD30 stain

CD30 stain

All images were provided by Dr. Mariusz Wasik, Professor of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center.

For more information on the NCCN recommendations for CD30 staining, click here.

References

  1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Hodgkin Lymphoma (Version 2.2013). © 2013 National Comprehensive Cancer Network, Inc. Available at NCCN.org. Accessed September 24, 2013.
  2. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Non-Hodgkin’s Lymphomas (Version 2.2013). © 2013 National Comprehensive Cancer Network, Inc. Available at NCCN.org. Accessed September 24, 2013.
  3. Wasik MA, Jimenez GS, Weisenburger DD. Targeting CD30 in malignant tissues: challenges in detection and clinical applications. Pathobiology. 2013;80(5):252-258.

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*Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Hodgkin’s Lymphomas V.2.2013 and Hodgkin Lymphoma V.2.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed September 24, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.