Abstract
BackgroundNodular lymphocyte predominant Hodgkin lymphoma (NLPHL) usually presents in middle aged men and shows an indolent clinical behavior. However, up to 30% of the patients present a secondary transformation into aggressive diffuse large B cell lymphoma (DLBCL). The aim of the present study was to characterize morphology and immunophenotype of this kind of DLBCL in detail and compare it with conventional DLBCL.MethodsMorphology and immunophenotype of 33 cases of NLPHL with simultaneous or sequential transformation into DLBCL were investigated. These cases were compared with 41 de novo DLBCL in Finnish men.ResultsThe majority of cases exhibited different immunophenotypes in the NLPHL and the DLBCL components. The immunophenotype of the DLBCL secondary to NLPHL was heterogeneous. However, BCL6, EMA, CD75 and J-chain were usually expressed in both components (≥73% positive). Overall, the NLPHL component was more frequently positive for EMA, CD75 and J-chain than the DLBCL component. In contrast, B cell markers, CD10 and BCL2, were more frequently expressed and were expressed at higher levels in the DLBCL component than in the NLPHL component. In the independent series of de novo DLBCL 4 cases could be identified with a growth pattern and immunophenotype that suggested that they had arisen secondarily from NLPHL.ConclusionsThe morphology and immunophenotype of DLBCL arisen from NLPHL is heterogeneous. Further characterization of the particular molecular features of this subgroup is warranted to be able to better identify these cases among conventional DLBCL.
Highlights
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) usually presents in middle aged men and shows an indolent clinical behavior
Patients with sequential transformation showed a non-significant trend towards worse overall and progression free survival compared to patients with simultaneous presentation of NLPHL and diffuse large B cell lymphoma (DLBCL) (Additional file 2: Figure S1)
Independent series of conventional DLBCL In order to compare DLBCL transformed from NLPHL (“LP type” DLBCL) with conventional DLBCL and to identify more cases that may be derived from NLPHL, we evaluated an independent series of 41 DLBCL for their morphology and immunophenotype
Summary
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) usually presents in middle aged men and shows an indolent clinical behavior. Up to 30% of the patients present a secondary transformation into aggressive diffuse large B cell lymphoma (DLBCL). The aim of the present study was to characterize morphology and immunophenotype of this kind of DLBCL in detail and compare it with conventional DLBCL. In the past 20 years, simultaneous or secondary transformation of NLPHL into diffuse large B cell lymphoma (DLBCL) has been described in up to 30% of cases [13,14,15,16,17,18]. The aim of the present study was to characterize morphology and immunophenotype of DLBCL simultaneously or sequentially derived from NLPHL in 33 cases. A second aim was the comparison of the immunophenotype observed in these particular cases with conventional DLBCL, in order to identify a marker panel, which allows to detect DLBCL, representing a putative transformation from NLPHL, in an independent series of DLBCL
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