Immunoarchitectural patterns in nodular lymphocyte predominant Hodgkin lymphoma: pathologic and clinical implications

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.