The clinical relevance of CD30

Appropriate management of patients with lymphoma depends on an accurate diagnosis.1 Immunophenotyping improves diagnostic accuracy by 10% to 45% for a number of major lymphoma subtypes.2

CD30 was initially discovered on Reed-Sternberg cells in Hodgkin lymphoma (HL), and it remains an important diagnostic marker that is expressed in >98% of HL cases.3,4,5 In non-Hodgkin lymphoma (NHL), immunohistochemistry (IHC) for CD30 should be considered the standard of care in the diagnostic algorithm for peripheral T-cell lymphoma (PTCL).6

While CD30 is expressed to varying degrees in many T-cell lymphomas, all cases of systemic anaplastic large cell lymphoma (sALCL) are CD30-positive with a uniform strong expression pattern.6,7 In the differential diagnosis of sALCL vs peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), pattern and intensity of CD30 expression can help differentiate.

In B-cell NHLs, including diffuse large B-cell lymphoma (DLBCL) and post-transplant lymphoproliferative disorders, CD30 is considered useful under certain circumstances to establish a diagnosis.6

Screening for CD30 can assist with the differential diagnosis of PTCL

sALCL

sALCL

All cases are CD30-positive7
Large malignant cells strongly express CD30 on the cell membrane8

PTCL-NOS: small/medium cell variant.

PTCL-NOS: small/medium cell variant

Approximately 32% of PTCL-NOS cases have some CD30-positive cells9
Expression is usually focal and/or weak8,10

PTCL-NOS: large cell variant.

PTCL-NOS: large cell variant

Cases with strong diffuse CD30 expression are occasionally encountered9

All images were provided by Dr. Graham Slack, Pathology Oncologist, BC Cancer Agency, Assistant Clinical Professor, University of British Columbia, British Columbia, Canada.

For more information on the role of CD30 in the differential diagnosis of NHL, click here.

References

  1. Matasar MJ, Shi W, Silberstien J, et al. Expert second-opinion pathology review of lymphoma in the era of the World Health Organization classification. Ann Oncol. 2012;23(1):159-166.
  2. The Non-Hodgkin’s Lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group Classification of Non-Hodgkin’s Lymphoma. Blood. 1997;89(11):3909-3918.
  3. Schwab U, Stein H, Gerdes J, et al. Production of a monoclonal antibody specific for Hodgkin and Sternberg-Reed cells of Hodgkin’s disease and a subset of normal lymphoid cells. Nature. 1982;299(5878):65-67.
  4. Stein H, Gerdes J, Schwab U, et al. Identification of Hodgkin and Sternberg-Reed cells as a unique cell type derived from a newly-detected small-cell population. Int J Cancer. 1982;30(4):445-459.
  5. von Wasielewski R, Mengel M, Fischer R, et al. Classical Hodgkin’s disease: clinical impact of the immunophenotype. Am J Pathol. 1997;151(4):1123-1130.
  6. 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.
  7. Inghirami G, Pileri SA; and European T-Cell Lymphoma Study Group. Anaplastic large-cell lymphoma. Semin Diagn Pathol. 2011;28(3):190-201.
  8. Ferreri AJM, Govi S, Pileri SA, Savage KJ. Anaplastic large cell lymphoma, ALK-negative. Crit Rev Oncol Hematol. 2013;85(2):206-215.
  9. Savage KJ, Harris NL, Vose JM, et al; for International Peripheral T-Cell Lymphoma Project. ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-cell Lymphoma Project. Blood. 2008;111(12):5496-5504.
  10. Zettl A, Rüdiger T, Konrad MA, et al. Genomic profiling of peripheral T-cell lymphoma, unspecified, and anaplastic large T-cell lymphoma delineates novel recurrent chromosomal alterations. Am J Pathol. 2004;164(5):1837-1848.

MORE UPDATES

NCCN recommends CD30-thumb

NCCN recommends CD30

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

Clinical relevance of CD30-thumb

The clinical relevance of CD30

Appropriate management of patients with lymphoma depends on an accurate diagnosis...

CD30 in NHL prognosis-thumb

CD30 in NHL prognosis

The definitive role of prevalence and intensity of CD30 in prognosis is evolving...

melanoma-thumb

Study finds CD30 in 17 cancers

In a study of over 1,500 patients with nonlymphomatous malignancies, 17 different diagnoses were associated...

burkitt-thumb

CD30 in Burkitt lymphoma

25% of Burkitt lymphoma cases express CD30. The endemic variant, African Burkitt lymphoma...

ptcl OS-thumb

CD30 and overall survival in PTCL‑NOS

A recent study found that CD30 expression is an adverse predictor of survival in peripheral T-cell lymphoma...

germ vells thumb

CD30 screening in germ cell tumors

CD30 is strongly expressed in more than 95% of embryonal carcinomas, while other germ cell tumors lack CD30...

methods thumb

Methods of detecting CD30

CD30 expression can be analyzed using immunohistochemistry on fixed tissue or flow cytometry on live cells...

*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.