Immunohistochemical Expression of CD45RA and CD45RO in Non-Hodgkin Lymphomas: A Prospective Observational Study
DOI:
https://doi.org/10.21276/apalm.3931Keywords:
non-Hodgkin lymphoma, immunohistochemistry, CD45RA, CD45RO, B-cell lymphoma, T-cell lymphomaAbstract
Background: Non-Hodgkin lymphomas (NHL) are heterogeneous lymphoid neoplasms, 85–90% of B-cell origin. CD45RA is expressed on B cells and naïve T cells, whereas CD45RO is expressed mainly on activated and memory T cells.Aim: To evaluate immunohistochemical expression of CD45RA and CD45RO in NHL and assess their utility in distinguishing B-cell from T-cell lymphomas.
Materials and methods: This prospective observational study included 60 newly diagnosed NHL cases on lymph node biopsy, classified by World Health Organization criteria, and 30 reactive lymph nodes as controls. A standard lymphoma panel was supplemented with CD45RA (clone 4KB5) and CD45RO (clone UCHL1). Two pathologists blinded to the final diagnosis scored both markers independently. Proportions are given with Wilson 95% confidence intervals (CI) and compared by Fisher's exact test.
Results: Forty cases (66.7%) were B-cell and 20 (33.3%) T-cell NHL. CD45RA was positive in 45 cases (75.0%; 95% CI 62.8–84.2) and CD45RO in 31 (51.7%; 95% CI 39.3–63.8). All 40 B-cell NHL expressed CD45RA, and 11 (27.5%) co-expressed CD45RO. All 20 T-cell NHL expressed CD45RO, and 5 (25.0%) co-expressed CD45RA. Both associations were significant (CD45RA, p = 2.9 × 10⁻¹⁰; CD45RO, p = 2.3 × 10⁻⁸). Sensitivity was 100% for each marker, but specificity only 75.0% and 72.5% respectively.
Conclusion: CD45RA and CD45RO are useful lineage markers in NHL, but aberrant co-expression in about a quarter of cases means a negative result excludes a lineage more reliably than a positive result confirms it. They should be interpreted alongside morphology and a lineage-restricted panel.
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