Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) with CD30-positive lymphocyte-predominant (LP) cells

Abstract

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a distinct neoplasm within the spectrum of Hodgkin lymphomas with characteristic clinical, morphological, and immunohistochemical features. According to the WHO definition, lymph nodes involved by NLPHL should have a nodular or nodular and diffuse proliferation of scattered large neoplastic lymphocyte-predominant (LP) cells in a small cell background that reside in expanded follicular dendritic cell meshworks; the LP cells must also have a distinct immunophenotypic profile. The LP cells are monoclonal B cells that are typically CD20, BCL6, CD79a, and CD45 positive and are CD30 and CD15 negative. In contrast, the Reed-Sternberg cells of classical Hodgkin lymphoma (CHL) are typically positive for CD15 and CD30. However, in CHL, CD20 staining is variable, and CD15 staining may be absent in some cases. Thus, CD30 is often considered to be the most distinctive marker between CHL and NLPHL. In order to better assess CD30 staining in NLPHL, we reviewed 220 cases of NLPHL and found 21 cases that showed at least focal staining of the neoplastic cells for CD30. The CD30 staining was often faint, but occasionally strong, and typically was found only on a subset of the LP cells. We evaluated the clinicopathologic features of these cases to determine whether they showed differences from typical CD30-negative NLPHL and found no significant difference with respect to clinical presentation, histology, other immunophenotypic features or outcome. In summary, we conclude that CD30 expression by LP cells in NLPHL can be seen and should not lead to a misdiagnosis of CHL. The presence of CD30-positive LP cells is not associated with other features of CHL or unusually aggressive behavior.

EBV May Be Expressed in the LP Cells of Nodular Lymphocyte–predominant Hodgkin Lymphoma (NLPHL) in Both Children and Adults

“…The remaining patients were residents of the United States or Canada. Biopsied lymph nodes included cervical (4), axillary (4), submandibular (2), and supraclavicular (2) locations. Patient 12 had a history of stage IA CHL diagnosed 9 years earlier, but this material was not available for our review.…”

“…While this disparity may be due to differences in antibody choice or staining techniques, CD30 positive cases were identified from all 3 participating institutions in our study. Moreover, a recent study found a relatively high incidence of variable CD30 expression in LP cells (2). …”

“…LP cells maintain a B-cell phenotype, with expression of CD20, CD79a, OCT-2, and BOB.1 as well as CD45 and BCL6. LP cells may also be positive for EMA, but CD30 and CD15 are typically negative (2-4). The prognosis of NLPHL patients is generally good, although the disease frequently relapses after prolonged periods of remission (5).…”

Thomas Hodgkin and Hodgkin lymphoma

“…1). In occasional cases, the LP cells express CD30, but the CD30 is usually weak and expressed by only a subset of the neoplastic cells [15]. A subset of NLPHL has IgD+ LP cells (27 % in one large series) [16].…”

A Clinical and Pathological Comparison of Different Immunomorphological Subvariants of Nodular Lymphocyte-Predominant Hodgkin’s Lymphoma at Initial Diagnosis

“…-L&H-клетки), которые одинаково интенсивно экспрессируют CD20 и В-клеточные транскрипционные факторы (PAX5, BOB.1, Oct.2) и окружены розетками из Т-лимфоцитов с иммунофенотипом Tfh (follicular helper T сells: CD3+, PD1+), причем нередко в патологоанатомической практике используется суррогатный маркер Tfh -CD57. В большинстве случаев НЛХЛП отсутствует экспрессия CD30 и CD15 [3].…”