Primary Extranodal Nodular Lymphocyte Predominant Hodgkin Lymphoma Involving the Thyroid

Abstract

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon lymphoma that accounts for 3-8% of all Hodgkin lymphomas. NLPHL typically presents as early stage disease with localized peripheral lymphadenopathy. Involvement of extranodal sites at the time of presentation occurs in 6% of cases and most commonly involves the spleen, liver, bone marrow, and Waldeyer ring. Primary extranodal NLPHL is exceedingly rare. We describe the first reported case involving the thyroid and review the six other previously described cases of primary extranodal NLPHL.

Diagnostic challenge of soft tissue extranodal Hodgkin lymphoma in core-needle biopsy: case report

“…Between all diseases that may be diagnosed by needle biopsy, lymphomas are among greatest challenges for pathologists. According to literature data the fine-needle aspiration was inconclusive for diagnosis of primary extranodal nodular lymphocyte predominant HL involving the thyroid, 9 primary cHL of parotid gland, 8 nodular sclerosing HL involving breast, 6 as well as fine-needle biopsy was inadequate for primary breast HL. 7 Diagnostic problem arises when needle biopsy samples must allow not only diagnosis of lymphoma but also accurate lymphoma subtyping in order to initiate the therapy.…”

“…3,4 Among Chine patients the most commonly involved extranodal sites of HL are the liver and lung, followed by the bones. 5 Rare cases are also described as primary breast, 6,7 parotid gland, 8 thyroid, 9 rectosigmoid, 10,11 ileum, 12 and head and neck 13,14 HL. It is essential to determine whether extranodal involvement represents a primary manifestation or dissemination of systemic disease.…”