Progression of Nodular Lymphocyte-Predominant Hodgkin?s Lymphoma to a High-Grade Lymphoma

Riley Jm,Milligan L,Zauls Aj,Jenrette Jm,Stuart Rk,Gordon L

doi:10.4172/2157-7013.s2-001

Abstract

Nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) is a rare subtype of Hodgkin’s lymphoma characterized by a nodular proliferation of large neoplastic B cells that are CD15 and CD30 negative. Although this neoplasm develops slowly and has a favorable prognosis with Stage I or II disease, it has a high rate of recurrence and patients tend to have repeated relapses [1]. Increasingly, reports have shown that a small percentage of patients with NLPHL may transform to a more aggressive lymphoma concurrently or many years later. This case highlights a 58 year-old man who developed NLPHL at age 33 and progressed to a high-grade malignant lymphoma 25 years later. The purpose of this report is to share this patient’s unusual clinical course and provide a pertinent literature review of NLPHL.

Highlights

The World Health Organization (WHO) classifies Hodgkin’s lymphoma into two different subtypes consisting of classical Hodgkin’s lymphoma and nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) [1]
The two subtypes differ in that classical Hodgkin’s lymphoma contains Reed-Sternberg cells that stain positive for CD15 and CD30 whereas NLPHL has Reed-Sternberg cell variants, termed Lymphocyte Predominant (LP) or popcorn cells, that are CD15 and CD30 negative [1,5]
An additional distinguishing feature between the two is that LP cells stain positive for the B lymphocyte marker CD20, making NLPHL an unusual form of a B cell lymphoma [6]

Summary

Introduction

The World Health Organization (WHO) classifies Hodgkin’s lymphoma into two different subtypes consisting of classical Hodgkin’s lymphoma and nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) [1]. NLPHL is much less common and accounts for only 5% of all Hodgkin’s lymphomas [1,2]. The two subtypes differ in that classical Hodgkin’s lymphoma contains Reed-Sternberg cells that stain positive for CD15 and CD30 whereas NLPHL has Reed-Sternberg cell variants, termed Lymphocyte Predominant (LP) or popcorn cells, that are CD15 and CD30 negative [1,5]. Many patients with NLPHL have favorable outcomes, there is increasing evidence that this subtype may progress to a more aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL), concurrently or many years later [7,8]

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