Nodular lymphocyte predominant Hodgkin lymphoma at atypical locations may be associated with increased numbers of large cells and a diffuse histologic component

Yang, David T.; Dunphy, Cherie H.; Tripp, Sheryl R.; Lagoo, Anand S.; Perkins, Sherrie L.

doi:10.1002/ajh.21077

Cited by 6 publications

(13 citation statements)

References 22 publications

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“…The patients were predominantly males in the 40 to 50-year-old age range who presented with localized peripheral lymphadenopathy of the cervical, axillary, and inguinal lymph nodes. The incidence of recurrent/progressive disease in our series (4/17 cases, 23%) is not significantly different from that reported for typical NLPHL [24,25].…”

Section: Discussioncontrasting

confidence: 84%

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

et al. 2011

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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.

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Section: Discussioncontrasting

confidence: 84%

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

et al. 2011

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“…According to Yang et al, NLPHL presented in other 'atypical' sites such as retroperitoneal lymph nodes, mesenteric and choledochal lymph nodes and the lacrimal gland might represent a possible different histological or biological subset involving older patients and associated with increased number of large, BCL-2 expressing neoplastic cells and with a diffuse histological component [26]. Although this study did not include any tonsillar NLPHL, we stained for BCL-2 and did not detect positivity in LP cells.…”

Section: Discussionmentioning

confidence: 57%

Nodular lymphocyte-predominant Hodgkin lymphoma of the tonsil: a case study using immunohistochemistry and FISH analysis and review of the literature

Ιωάννου

Kouvaras

Gletsou³

et al. 2011

J Hematopathol

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Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma that differs from classic Hodgkin lymphoma with respect to histological and clinical presentations. This type of lymphoma typically affects predictable lymph node groups with excellent treatment outcomes. However, rare atypical locations have also been described and a possible diverse clinical or biological subtype has been suggested. We present a case of NLPHL arising in the tonsil of a 43-year-old man. The patient presented with a submucosal mass in an asymmetrically enlarged tonsil. Bilateral tonsillectomy was performed and histological examination showed effacement of the enlarged tonsil by nodules comprised of scattered large atypical cells having classic lymphocyte-predominant cell morphology in a background of benign B cells. Immunohistochemical analysis showed lack of CD15 and CD30 in the LP cells and strong expression of CD20, CD45, BCL-6 and epithelial membrane antigen (EMA). Interphase fluorescence in situ hybridization (FISH) analysis, revealed bcl-6 gene rearrangement in the LP cells. Although lymphoma is a common malignancy of the tonsil, there are only sporadic reports of NLPHL arising in this location and the differential diagnosis should include this entity. Histological, immunohistochemical and FISH findings are also discussed and the literature reviewed.

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“…and an additional case report appear to suggest the possibility that NLPHL may have areas with a confluent, syncytial appearance, leading to a morphological overlap with DLBCL 4,23 . On reviewing the literature, it appears that progression to DLBCL may be diagnosed when large B cells with or without features of LP cells form sheets and the association with FDC networks is lost in the diffuse areas 10–12 . Cases such as those described herein appear to represent very early transformation, as these areas represented only a focal and minor component of the overall lymph node involved by NLPHL.…”

Section: Discussionmentioning

confidence: 69%

“…However, cases of TCHRLBL have also been reported 11,19 . The DLBCL component usually occurs in sites other than the presenting site for the NLPHL 11,12 …”

Section: Discussionmentioning

confidence: 99%

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Nodular lymphocyte predominant Hodgkin lymphoma and diffuse large B-cell lymphoma: a study of six cases concurrently involving the same site

Cotta

Coleman

et al. 2011

Histopathology

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Nodular lymphocyte predominant Hodgkin lymphoma at atypical locations may be associated with increased numbers of large cells and a diffuse histologic component

Cited by 6 publications

References 22 publications

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

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

Nodular lymphocyte-predominant Hodgkin lymphoma of the tonsil: a case study using immunohistochemistry and FISH analysis and review of the literature

Nodular lymphocyte predominant Hodgkin lymphoma and diffuse large B-cell lymphoma: a study of six cases concurrently involving the same site

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