Abstract
Question: In contrast to the commonly indolent clinical behavior of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), T cell/histiocyte rich large B cell lymphoma (THRLBCL) is frequently diagnosed in advanced clinical stages and has a poor prognosis. Besides the different clinical presentations of these lymphoma entities, there are variants of NLPHL with considerable histopathologic overlap compared to THRLBCL. Especially THRLBCL-like NLPHL, a diffuse form of NLPHL, often presents a histopathologic pattern similar to THRLBCL. The present study therefore aimed to find markers, which can be applied in the differential diagnosis between NLPHL and THRLBCL.
Highlights
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a germinal center (GC) B cell derived neoplasm preferentially affecting young to middle aged male patients [1,2]
There was a continuous branching, and T cell/histiocyte rich large B cell lymphoma (THRLBCL)-like NLPHL cases were intermingled with THRLBCL cases
We found an important molecular overlap between the tumor cells of the different variants of NLPHL and THRLBCL
Summary
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a germinal center (GC) B cell derived neoplasm preferentially affecting young to middle aged male patients [1,2]. In most cases the histopathologic picture of NLPHL is dominated by a nodular infiltrate composed of small reactive B cells and only few tumor cells, the lymphocyte predominant (LP) cells [4]. Cases of NLPHL have been described showing a diffuse infiltrate of LP cells in a T cell and histiocyte-rich background [5,6]. Six NLPHL variant patterns have been defined by Fan et al, of which the patterns C and E most closely resemble T cell/histiocyte rich large B cell lymphoma (THRLBCL) (Fig. 1) [5]. Patients with NLPHL pattern E (in the following called THRLBCL-like NLPHL) develop relapses more frequently than patients with a typical nodular infiltrate [5]. 60%
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