Concanavalin A binding histiocytes in Hodgkin's disease and their relation to clinicopathologic features of the disease.

The occurrence and staining patterns of Concanavalin A (Con A) binding histiocytes were studied in diagnostic lymph node specimens of 133 patients with Hodgkin's disease. Varying numbers of Con A binding histiocytes were present in all tumors. Two distinct cytoplasmic staining patterns of the Con A binding histiocytes were noted: diffuse, and a pattern termed "globular" which represents a dense, solitary paranuclear aggregate of binding sites. The diffuse binding pattern was seen in the majority of histiocytes with no apparent nuclear atypia, but was also occasionally seen in Reed-Sternberg cells. Globular binding was present in both benign and malignant-looking histiocytes, including rare Reed-Sternberg cells. Based on the number of histiocytes in which globular binding of Con A (G-cells) was observed, tumors were grouped in the following three categories: Group 1: tumors with large numbers of G-cells (42 cases); Group 2: tumors with a small number of G-cells (16); and Group 3: tumors with rare or no G-cells (75). Tumors with large numbers of G-cells were seen more frequently in patients with disseminated disease than in those with localized (69.0% versus 31.0%; P less than or equal to 0.002), and more often in patients with B-symptoms than in those without (73.8% versus 26.2%; P less than or equal to 0.001). Large numbers of G-cells were present in most tumors of the lymphocyte depletion type (14/16), whereas rare or no G-cells were seen in the majority of the nodular sclerosis type (46/59). These observations suggest that the G-cells may represent an abnormal variant of histiocytes, the occurrence of which is associated with unfavorable clinical and pathologic features of Hodgkin's disease.