Nodular lymphocyte-predominant Hodgkin lymphoma
Jump to navigation
Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
Nodular lymphocyte-predominant Hodgkin lymphoma | |
---|---|
Diagnosis in short | |
Popcorn cell in nodular lymphocyte-predominant Hodgkin lymphoma | |
| |
LM | Popcorn cells (relatively) small (compared to classic RSCs) - have lobulated nucleus (key feature), small nucleoli; subtle nodularity at low power |
Subtypes | none |
LM DDx |
diffuse large B cell lymphoma (esp. T-cell/histiocytic-rich LBCL), anaplastic large cell lymphoma, B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, classical Hodgkin lymphoma |
IHC | LCA (CD45) +ve, CD20 +ve, CD10 +ve, Bcl-6 +ve, EMA +ve, CD30 -ve, CD15 -ve |
Site | usu. lymph node |
| |
Signs | lymphadenopathy |
Prevalence | uncommon |
Prognosis | good |
- AKA lympho-histiocytic variant.
- Abbreviated NLPHL.
- Different IHC and morphologic appearance than classic HL.
- Significant risk for transformation into diffuse large B cell lymphoma (DLBCL); 10-year cumulative transformation rate (to DLBCL) in one study was 12%.[1]
Microscopy
Features (nodular lymphocyte-predominant Hodgkin's lymphoma):
- Popcorn cell (previously known as Lymphocytic & histiocytic cell (L&H cell)[2]) - variant of RSC:
- Cells (relatively) small (compared to classic RSCs).
- Lobulated nucleus - key feature.
- Small nucleoli.
- Subtle nodularity at low power (2.5x or 5x objective).
IHC
Abbreviated panel:[3]
- CD30 Reed-Sternberg cells (RSCs) +ve ~98%
- CD15 Reed-Sternberg cells +ve ~80%, stains neutrophils.
- CD45 often negative in RSCs.
- CD20 may stain RSCs.
- PAX5 +ve.[4]
Additional - for completeness:
- CD3 (T lymphocytes)
NLPHL IHC differs from the classical HL:[4]
- LCA +ve.
- CD20 +ve.
- CD10 +ve.
- Bcl-6 +ve.
- EMA +ve.
- CD30 -ve
- CD15 -ve.
A panel
Antibody | NLPHL | CHL |
CD45 | +ve | -ve |
CD20 | +ve | -ve |
BCL6 | ||
MUM1[5] | -ve | |
CD30 | -ve | +ve (most sensitive). |
CD15 | -ve | +ve |
CD21 | networks present | no networks |
CD23 | networks present | no networks |
OCT-2 | +ve | -ve |
PAX5 | +ve | +ve (proves B cell linage) |
CD3 | usu. < benign B cell | usu. > benign B cell component |
CD57 | rosettes around malign. cells | - |
EBER | -ve | +ve/-ve |
EMA | +ve/-ve | -ve |
4 unstained |
Images (NLPHL)
www:
See also
References
- ↑ Biasoli I, Stamatoullas A, Meignin V, et al. (February 2010). "Nodular, lymphocyte-predominant Hodgkin lymphoma: a long-term study and analysis of transformation to diffuse large B-cell lymphoma in a cohort of 164 patients from the Adult Lymphoma Study Group". Cancer 116 (3): 631–9. doi:10.1002/cncr.24819. PMID 20029973.
- ↑ Küppers R, Rajewsky K, Braeuninger A, Hansmann ML (March 1998). "L&H cells in lymphocyte-predominant Hodgkin's disease". N. Engl. J. Med. 338 (11): 763–4; author reply 764–5. doi:10.1056/NEJM199803123381113. PMID 9499174.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 568. ISBN 978-0781765275.
- ↑ 4.0 4.1 Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 683. ISBN 978-1416025887.
- ↑ URL: http://www.ncbi.nlm.nih.gov/omim/601900. Accessed on: 10 August 2010.