Nodular Lymphocyte Predominant Hodgkin’s Lymphoma with T Cell/ Histiocyte Rich Large B Cell Lymphoma Like Transformation

Authors

  • Sakshi Batra VMMC and Safdarjung Hospital, Delhi, India
  • Harsh Batra VMMC & Safdarjung Hospital, New Delhi, India
  • Charanjeet Ahluwalia VMMC & Safdarjung Hospital, New Delhi, India
  • Sunil Ranga VMMC & Safdarjung Hospital, New Delhi, India

DOI:

https://doi.org/10.21276/apalm.2869

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.

Author Biographies

Sakshi Batra, VMMC and Safdarjung Hospital, Delhi, India

Department of Pathology and Laboratory Medicine

Harsh Batra, VMMC & Safdarjung Hospital, New Delhi, India

Department of Pathology and Laboratory Medicine

Charanjeet Ahluwalia, VMMC & Safdarjung Hospital, New Delhi, India

Department of Pathology and Laboratory Medicine

Sunil Ranga, VMMC & Safdarjung Hospital, New Delhi, India

Department of Pathology and Laboratory Medicine

References

1. Swerdlow SH, International Agency for Research on Cancer, World Health Organization (2008) WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon, France: International Agency for Research on Cancer. 439 p. p.
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.

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Published

01-09-2020

How to Cite

1.
Batra S, Batra H, Ahluwalia C, Ranga S. Nodular Lymphocyte Predominant Hodgkin’s Lymphoma with T Cell/ Histiocyte Rich Large B Cell Lymphoma Like Transformation. Ann of Pathol and Lab Med [Internet]. 2020 Sep. 1 [cited 2024 Dec. 5];7(8):C103-106. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/2869

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Section

Case Report