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Terminal Deoxynucleotidyl Transferase–Positive Lymphoid Cells in Reactive Lymph Nodes From Children With Malignant Tumors
Incidence, Distribution Pattern, and Immunophenotype in 26 Patients

Mihaela Onciu MD, Robert B. Lorsbach MD, PhD, E. Charlene Henry HTL(ASCP)QIHC, Frederick G. Behm MD
DOI: http://dx.doi.org/10.1309/L3UW-3AE7-L4LB-3QX3 248-254 First published online: 1 August 2002

Abstract

The presence of terminal deoxynucleotidyl transferase (TdT)-positive lymphoid precursors in benign lymph nodes from children has been characterized insufficiently. By using single- and double-labeling immunohistochemical analysis, we examined the frequency, distribution, morphologic features, and immunophenotype of TdT-positive cells in benign lymph nodes from 26 consecutive pediatric patients (4 boys, 22 girls; age, 10 weeks-17 years; median, 4.5 years), 23 of whom had a history of malignant neoplasm. We identified TdT-positive lymphoid cells in all 26 cases. These cells were found adjacent to medullary and cortical sinuses, with a frequency of 1 to 180 cells per high-power field (median, 20 cells), and were present singly and in small clusters. They were morphologically heterogeneous and showed a precursor B-cell immunophenotype including colocalization with CD34 by single-antibody immunohistochemical analysis and coexpression of variable levels of CD79a and CD10 and lack of CD3 expression by double immunostaining. These features should aid in the evaluation of pediatric lymph nodes for partial involvement by lymphoblastic lymphoma/ leukemia.

Key Words:
  • TdT
  • Terminal deoxynucleotidyl transferase
  • Precursor B cell
  • Lymph node