{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T12:51:11Z","timestamp":1775479871925,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Despite increasing interest in the recently established immunoglobulin 4\u2010related disease (IgG4\u2010RD), its pathogenesis and aetiology remain largely unclear. Characteristic histopathological features are one of the key elements of diagnosis, including \u2018storiform\u2019 fibrosis, obliterative phlebitis, increased lymphoplasmacytic infiltration and increased levels of IgG4 in serum and tissue. Histopathological features of IgG4\u2010RD are striking but not specific, and can pose a pitfall for surgical pathologists. This paper aims to determine the actual amount of IgG4+ plasma cells in nodular\u2010sclerosing Hodgkin lymphoma (NSHL) and its potential to be misdiagnosed in routine clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>IgG4+ plasma cells per high\u2010power field (HPF) and the ratio of IgG4+ versus IgG+ plasma cells (IgG4\/IgG ratio) in lymph node biopsies of 24 patients with nodular\u2010sclerosing Hodgkin lymphoma (NSHL) were determined using immunohistochemistry and consensus scoring criteria as used for IgG4\u2010RD. Ten lymph node biopsies with reactive follicular hyperplasia were assessed for comparison. Higher numbers of IgG4+ plasma cells (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) were observed in NSHL versus follicular hyperplasia (mean 34\u00a0versus 8 per HPF) with a mean IgG4\/IgG ratio of 0.38 versus 0.18. Five cases (21%) fulfilled the consensus criteria of IgG4\u2010RD, with &gt;50 IgG4+ plasma cells per HPF and an IgG4\/IgG ratio of &gt;0.4. The mean count of IgG4+ plasma cells per HPF in NSHL varied greatly (3\u201388) with increased numbers of IgG4+ plasma cells seen near areas of fibrosclerosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Significantly higher levels of IgG4+ plasma cells are common in NSHL, emphasising the need to exclude Reed\u2013Sternberg cells by morphology and immunohistochemistry in biopsies where IgG4\u2010RD is suspected.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13965","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T10:49:20Z","timestamp":1564742960000},"page":"244-250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Increased IgG4\u2010positive plasma cells in nodular\u2010sclerosing Hodgkin lymphoma: a diagnostic pitfall"],"prefix":"10.1111","volume":"76","author":[{"given":"Verena","family":"Nowak","sequence":"first","affiliation":[{"name":"Institute of Pathology Rheinisch Friedrich\u2010Wilhelm University University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Agaimy","sequence":"additional","affiliation":[{"name":"Institute of Pathology Friedrich\u2010Alexander University Nuremberg\u2010Erlangen University Hospital Erlangen Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-5487","authenticated-orcid":false,"given":"Glen","family":"Kristiansen","sequence":"additional","affiliation":[{"name":"Institute of Pathology Rheinisch Friedrich\u2010Wilhelm University University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2609-3095","authenticated-orcid":false,"given":"Ines","family":"G\u00fctgemann","sequence":"additional","affiliation":[{"name":"Institute of Pathology Rheinisch Friedrich\u2010Wilhelm University University Hospital Bonn Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-003-1175-y"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182027717"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-017-2275-z"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2012.07.001"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2012.72"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00292-013-1848-0"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-011-0571-z"},{"key":"e_1_2_7_9_1","first-page":"10153","article-title":"IgG4\u2010related lymphadenopathy: a potentially under\u2010and over\u2010diagnosed entity","volume":"10","author":"Zenggang Pan JZ","year":"2017","journal-title":"J. Clin. Exp. 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