[Nodular lymphocyte predominance Hodgkin's disease and its differential diagnosis]

Ann Pathol. 2004 Apr;24(2):136-48; quiz 135. doi: 10.1016/s0242-6498(04)93937-5.
[Article in French]

Abstract

Nodular lymphocyte predominance Hodgkin's disease (NLPHD), previously called nodular paragranuloma, is a rare entity recognized as a clinico-pathological entity distinct from classic Hodgkin's lymphoma. It is an indolent B cell lymphoma derived from a germinal center cell. NLPHD may closely resemble lymphocyte-rich classic Hodgkin's disease (LR-CHD) or T-cell or histiocyte-rich large B-cell lymphoma (TCRLBCL). A reproducible distinction between these entities is difficult but the classification is prognostically relevant. NLPHD is characterized by neoplastic "popcorn" cells CD20+ CD30- CD15- EMA+ Bcl6+ scattered within a nodular background predominantly composed of small B lymphocytes. LR-CHD neoplastic proliferation is composed of CD20+/- CD30+ CD15+/- EMA- Bcl6+/- Reed Sternberg or Hodgkin's cells, scattered within numerous CD3+ T cells. TCRLBCL is an agressive lymphoma composed of CD20+ CD30- CD15- EMA+/- Bcl6+/- polymorphic neoplastic cells, scattered within a mixture of CD3+ T cells and histiocytes. Epstein Barr virus is detectable within half cases of LR-CHD, but never in NLPHD and rarely in TCRLBCL. The transcription factors BOB1, PU-1, BSAP and IRF4 are new markers that could be useful for differential diagnosis.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antigens, CD / analysis
  • Cell Transformation, Neoplastic
  • Diagnosis, Differential
  • Hodgkin Disease / classification
  • Hodgkin Disease / pathology*
  • Humans
  • Lymphocytes / pathology*

Substances

  • Antigens, CD