Geographic Variability of Nodular Lymphocyte-Predominant Hodgkin Lymphoma: A Clinicopathologic Reappraisal in the Modern Era. Issue 2 (20th September 2021)

• Record Type: Journal Article
• Authors: Xia, Daniel; Sayed, Shahin; Moloo, Zahir; Gakinya, Samuel M; Mutuiri, Anderson; Wawire, Jonathan; Okiro, Patricia; Courville, Elizabeth L; Hasserjian, Robert P; Sohani, Aliyah R
• Is Part Of: American journal of clinical pathology. Volume 157:Issue 2(2022)
• Page Start: 231
• Page End: 243
• Publication Date: 2021-09-20
• Subjects: Nodular lymphocyte-predominant Hodgkin lymphoma -- Classic Hodgkin lymphoma -- Epstein-Barr virus -- IgD -- T cell rich -- Low/middle-income country; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqab113
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) differs from classic Hodgkin lymphoma (CHL) in terms of clinicopathologic features, including Epstein-Barr virus (EBV) association. CHL geographic variability is well known, with higher frequencies of mixed-cellularity subtype and EBV positivity in low/middle-income countries (LMICs), but there are few well-characterized series of NLPHL from LMICs. Methods: We detail clinicopathologic findings of 21 NLPHL cases received in consultation from Kenya and summarize reports of NLPHL with EBV testing published since 2000. Results: Median age of consultation cases was 36 years, and male/female ratio was 3.2. All cases involved peripheral lymph nodes and showed at least some B-cell–rich nodular immunoarchitecture, with prominent extranodular lymphocyte-predominant (LP) cells and T-cell–rich variant patterns most commonly seen. LP cells expressed pan–B-cell markers, including strong OCT2; lacked CD30 and CD15 expression in most cases; and were in a background of expanded/disrupted follicular dendritic cell meshworks and increased T-follicular helper cells. LP cells were EBV negative in 18 cases. Historical cases showed a low rate of EBV positivity with no significant difference between LMICs and high-income countries. Conclusions: Unlike CHL, NLPHL shows few geographic differences in terms of clinicopathologic features and EBV association. These findings have implications for diagnosis, prognostication, and treatment of patients with NLPHL in LMICs.