Is GATA3 Useful for Differentiating between Classical Hodgkin Lymphoma and Nodular Lymphocyte-Predominant Hodgkin lymphoma? A Two-Center Study in Tehran, Iran during 2016 to 2022

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OBJECTIVE: Hodgkin's lymphoma (HL) has two main types; classic HL and nodular lymphocyte predominant HL (NLPHL) which should be differentiated due to the differences in treatment options and prognosis. While a reliable immune panel exists for the diagnosis of Hodgkin Lymphoma, there are instances where certain cases may not align perfectly with established categories. Hence, further research is required to discover more accurate and specific markers. The current study aimed to evaluate GATA3 immunohistochemical expression pattern in classic HL and NLPHL. METHODS: This retrospective cross-sectional study was conducted on patients with HL diagnosis who were referred to the Imam Khomeini and Dr. Shariati Hospitals, Tehran, Iran from 2016 to 2022. Clinical and demographic data were collected from medical records, while immunohistochemical staining and evaluation were performed on paraffin-embedded tissue blocks. GATA3 expression was considered positive if nuclear staining was seen in neoplastic cells. The staining intensity was graded as weak (+1), medium (+2) and strong (+3). RESULT: Out of the 60 samples analyzed (30 classic HL and 30 NLPHL samples), the average age of NLPHL patients (36.7 ± 16.44) was significantly higher compared to classic HL patients (28.6 ± 13.88, p=0.031). GATA3 nuclear expression was present in 63.3% of classic HL samples, while no expression was observed in NLPHL samples. Different levels of staining weak, medium, and strong were found in 20%, 26.7%, and 16.7% of the samples, respectively. There was no correlation between GATA3 expression intensity and overall expression with gender, age group, or histologic subtypes (p>0.05). CONCLUSION: Differentiating between classic HL and NLPHL can be aided by the presence of GATA3 expression, which favors cHL; however, its absence does not provide a diagnostic tool for classification of HL.

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