# Role of immunohistochemistry in differentiating between reactive and malignant lymphoid hyperplasia - A cross-sectional study

**Authors:** Sakshi Chourasia, Seema Badkur, Ajit Kumar, Mitesh Shah

PMC · DOI: 10.6026/973206300213470 · 2025-10-31

## TL;DR

This study shows how immunohistochemistry helps distinguish between benign and cancerous lymph node growth, improving diagnosis and treatment decisions.

## Contribution

The study demonstrates the pivotal role of immunohistochemistry in accurately differentiating reactive from malignant lymphoid hyperplasia.

## Key findings

- Immunohistochemistry confirmed lineage specificity and identified aberrant antigen expression in lymphoid proliferations.
- IHC improved diagnostic accuracy and reduced misclassification of lymphoid hyperplasia cases.
- Proliferative indices from IHC markers helped guide therapeutic decisions in patients with lymphadenopathy.

## Abstract

Differentiating reactive lymphoid hyperplasia from malignant lymphoma poses a diagnostic challenge due to overlapping clinical and
histopathological features. Therefore, it is of interest to evaluate the utility of immunohistochemistry (IHC) in distinguishing benign
reactive changes from malignant lymphoid proliferations. Lymph node biopsies from patients presenting with persistent lymphadenopathy
were assessed histologically and subjected to a panel of IHC markers including CD3, CD20, CD10, BCL2 and Ki-67. The analysis revealed
that IHC not only confirmed lineage specificity but also helped to identify aberrant antigen expression and proliferative indices
characteristic of malignancy. Thus, we show the pivotal role of IHC in improving diagnostic accuracy, reducing misclassification and
guiding appropriate therapeutic decisions in patients with lymphoid hyperplasia.

## Linked entities

- **Proteins:** cd.3 (Cd.3 conserved hypothetical protein), MS4A1 (membrane spanning 4-domains A1), MME (membrane metalloendopeptidase), BCL2 (BCL2 apoptosis regulator), Mki67 (antigen identified by monoclonal antibody Ki 67)
- **Diseases:** lymphoma (MONDO:0003659), lymphadenopathy (MONDO:0005833)

## Full-text entities

- **Genes:** BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, MME (membrane metalloendopeptidase) [NCBI Gene 4311] {aka CALLA, CD10, CMT2T, NEP, SCA43, SFE}, KRT20 (keratin 20) [NCBI Gene 54474] {aka CD20, CK-20, CK20, K20, KRT21}
- **Diseases:** lymphoid hyperplasia (MESH:D019310), lymphadenopathy (MESH:D008206), malignancy (MESH:D009369), malignant lymphoma (MESH:D008223)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12859335