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Abstract
Diagnostic features of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) include a nodular, or a nodular and diffuse, proliferation of scattered tumor cells, set within a background of B cells reminiscent of primary or secondary lymphoid follicles. On morphologic and immunohistologic grounds, six different patterns have been recognized in NLPHL. An additional nodular pattern of NLPHL, in which lymphocyte predominant cells reside in an environment reminiscent of lymphoid follicles and do not spread to the extranodular space, has been identified. Recently, the prognostic impact of ‘histopathologic NLPHL variants’, which include cases characterized by the presence of lymphocyte predominant cells outside the B-cell nodules or B-cell depletion of the microenvironment has been evaluated. These ‘histopathologic variants’ were associated with advanced stage disease and higher relapse rate. Therefore, assessing and defining ‘histopathologic variants’ patterns in NLPHL may be useful for the management of the patients.
Financial & competing interests disclosure
The work has been supported in part by an Institutional Grant from the Centro di Riferimento Oncologico for a project on Molecular Pathology. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is classified as a distinct subtype of Hodgkin lymphoma.
NLPHL is a neoplasm usually associated with a favorable clinical course despite a tendency for local recurrences.
NLPHL typically presents in the early stages of the disease.
Well-recognized morphologic features of NLPHL include a nodular, or a nodular and diffuse, proliferation of scattered lymphocyte predominant (LP) tumor cells, set against a background of reactive lymphocytes reminiscent of a primary follicle.
On morphologic and immunohistologic grounds, different patterns are recognizable in NLPHL. Fan et al. identified six distinct immunoarchitectural patterns: ‘classical’ nodular, serpiginous/interconnected nodular, nodular with prominent extra-nodular LP cells, T-cell-rich nodular, diffuse with a T-cell-rich background, and diffuse, B-cell-rich pattern Citation[16].
An additional nodular pattern of NLPHL in which LP cells reside in an environment reminiscent of primary or secondary lymphoid follicles and do not invade the extranodular space has recently been recognized by Carbone and Gloghini Citation[18,19].
Hartmann et al. Citation[22] evaluated the prognostic implication of ‘histopathologic NLPHL variants’ versus pattern A and B of Fan et al. Citation[16].
The term ‘histopathologic variants’ was used by Hartmann et al. Citation[22] to define cases characterized by the presence of LP cells outside the B-cell nodules or B-cell depletion of the microenvironment.
Compared with typical NLPHL, ‘histopathologic variants’ were associated with more advanced disease and a higher relapse rate.