Nodular Lymphocyte Predominant Hodgkin’s Lymphoma with T Cell/ Histiocyte Rich Large B Cell Lymphoma Like Transformation
Keywords:
T-cell histiocyte-rich large B-cell lymphoma, THRLBCL, Hodgkin’s Lymphoma, NLPHL, LP cells, Immunohistochemistry
Abstract
Nodular lymphocyte predominant Hodgkin’s lymphoma (NLPHL) is an uncommon variant form of Hodgkin’s lymphoma with a worldwide incidence of 5%. 1 It has long been recognized that NLPHL can have varied growth patterns, including some with diffuse areas and/or numerous T cells.2 NLPHL may evolve to a completely diffuse T-cell–rich proliferation lacking any follicular dendritic cells which would be consistent with a T-cell histiocyte-rich large B-cell lymphoma (THRLBCL) or can be associated with such a proliferation at a separate site. Recent data indicate that progression to a process with features of THRLBCL is associated with a more aggressive clinical course, and requires different management, hence the significance of diagnosing correctly THRLBCL-like transformation of NLPHL. We report a case of THRLBCL-like transformation of NLPHL in an 11-year old male child.References
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11. Brune V, Tiacci E, Pfeil I, et al. Origin and pathogenesis of nodular lymphocyte-predominant Hodgkin lymphoma as revealed by global gene expression analysis. J Exp Med ;2008:2251-68.
12. Zhao FX. Nodular lymphocyte-predominant Hodgkin lymphoma or Tcell/histiocyte-rich large B-cell lymphoma: the problem in “grey zone” lymphomas. Int J Clin Exp Pathol 2008;1:300-5.
13. Rudiger T, Jaffe ES, Delsol G, et al. Workshop report on Hodgkin's disease and related diseases (‘grey zone’ lymphoma). Ann Oncol 1998; 9(Suppl 5):S31-8
14. Hartmann S, Döring C, Jakobus C et al. (2013) Nodular Lymphocyte Predominant Hodgkin Lymphoma and T Cell/Histiocyte Rich Large B Cell Lymphoma - Endpoints of a Spectrum of One Disease? PLoS ONE 8(11): e78812. https://doi.org/10.1371/journal.pone.0078812
15. Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391-2405.
2. Fan Z, Natkunam Y, Bair E, Tibshirani R, Warnke RA (2003) Characterization of variant patterns of nodular lymphocyte predominant hodgkin lymphoma with immunohistologic and clinical correlation. Am J Surg Pathol 27: 1346–1356.
3. Küppers R, Rajewsky K, Zhao M, Simons G, Laumann R, et al. (1994) Hodgkin disease: Hodgkin and Reed-Sternberg cells picked from histological sections show clonal immunoglobulin gene rearrangements and appear to be derived from B cells at various stages of development. Proc Natl Acad Sci USA 91: 10962–10966.
4. Braeuninger A, Kuppers R, Strickler JG, Wacker HH, Rajewsky K, et al. (1997) Hodgkin and Reed-Sternberg cells in lymphocyte predominant Hodgkin disease represent clonal populations of germinal center-derived tumour B cells. Proc Natl Acad Sci U S A 94: 9337–9342.
5. Diehl V, Sextro M, Franklin J, Hansmann ML, Harris N, et al. (1999) Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin’s disease and lymphocyte-rich classical Hodgkin’s disease: report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin’s Disease. J Clin Oncol 17: 776–783
6. Marafioti T, Hummel M, Anagnostopoulos I, et al. (1997) Origin of nodular lymphocyte-predominant Hodgkin’s disease from a clonal expansion of highly mutated germinal-center B cells. N Engl J Med;337(7):453-458.
7. Steimle-Grauer SA, Tinguely M, Seada L, Fellbaum C, Hansmann ML. (2003) Expression patterns of transcription factors in progressively transformed germinal centers and Hodgkin lymphoma.Virchows Arch ;442(3):284-293.
8. Tedoldi S, Mottok A, Ying J, et al. (2007) Selective loss of B-cell phenotype in lymphocyte predominant Hodgkin lymphoma. J Pathol ;213(4):429-440.
9. Brune V, Tiacci E, Pfeil I, et al. (2008) Origin and pathogenesis of nodular lymphocyte-predominant Hodgkin lymphoma as revealed by global gene expression analysis. J Exp Med ;205(10):2251-2268.
10. Boudova L, Torlakovic E, Delabie J, Reimer P, Pfistner B, et al. (2003) Nodular lymphocyte-predominant Hodgkin lymphoma with nodules resembling T-cell/histiocyte-rich B-cell lymphoma: differential diagnosis between nodular lymphocyte-predominant Hodgkin lymphoma and T-cell/histiocyte-rich B-cell lymphoma. Blood 102: 3753–3758.
11. Brune V, Tiacci E, Pfeil I, et al. Origin and pathogenesis of nodular lymphocyte-predominant Hodgkin lymphoma as revealed by global gene expression analysis. J Exp Med ;2008:2251-68.
12. Zhao FX. Nodular lymphocyte-predominant Hodgkin lymphoma or Tcell/histiocyte-rich large B-cell lymphoma: the problem in “grey zone” lymphomas. Int J Clin Exp Pathol 2008;1:300-5.
13. Rudiger T, Jaffe ES, Delsol G, et al. Workshop report on Hodgkin's disease and related diseases (‘grey zone’ lymphoma). Ann Oncol 1998; 9(Suppl 5):S31-8
14. Hartmann S, Döring C, Jakobus C et al. (2013) Nodular Lymphocyte Predominant Hodgkin Lymphoma and T Cell/Histiocyte Rich Large B Cell Lymphoma - Endpoints of a Spectrum of One Disease? PLoS ONE 8(11): e78812. https://doi.org/10.1371/journal.pone.0078812
15. Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391-2405.
Published
2020-09-01
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Section
Case Report
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