Immunoarchitectural patterns of progressive transformation of germinal centers with and without nodular lymphocyte-predominant Hodgkin lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma

“…In these cases, the detection of T-cell rosettes surrounding the LP cells is helpful to establish the diagnosis. 8 Fan et al 9 described six histopathological growth patterns (termed A-F). Patterns A and B show a typical B-cell-rich background infiltrate, whereas patterns C-F either show a diffuse infiltrate or nodules dominated by T-cell bystander cells ( Fig.…”

“…Most reliable in this differential diagnosis is the detection of rosettes of follicular T helper (T FH ) cells, positive for PD1, which allow one to clearly detect LP cells, whereas in progressively transformed germinal centres only incomplete T FH rosettes around centroblasts are encountered. 8 The shape of nodules can also be of diagnostic help, since NLPHL nodules more frequently present with irregular forms and a moth-eaten appearance. Demonstration of high numbers of IgG4positive plasma cells within the B-cell nodules can additionally help to rule out NLPHL, since IgG4-positive plasma cells are only rarely detected in the NLPHL microenviroenment.…”

A rare face of follicular lymphoma: reverse variant of follicular lymphoma

“…The growth pattern of RVFL can mimic other lymphoproliferative disorders. Several differential diagnoses need to be considered, including but not limited to FL with marginal-zone differentiation, marginal zone lymphoma (MZL), progressive transformation of germinal centers (PTGC), nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) [13][14][15][16][17] and even anaplastic large cell lymphoma. FL with marginal-zone differentiation is one of the rare variants of FL.…”

“…PTGC differs from RVFL in that the nodules are often large, comprised mainly of small round lymphocytes instead of follicular center cells. Also, it is the clusters of epithelioid histiocytes at the margins of the nodules rendering the pale looking zone of PTGC nodules, whereas the pale cuffs in RVFL mainly comprise centroblasts [14,19].…”

New developments in the pathology of malignant lymphoma. A review of the literature published from September 2015–December 2015

“…The presence of regular large CD20-positive cells has been described as indicative of NLPHL, but in practice, I prefer the criterium that the lesions need to have a mass effect, a disturbance of the lymph node architecture. Hartmann et al [ 15 ] describe the morphologic features of 160 cases of PTGC for better delineation of PTGC from early involvement by NLPHL (although I do not know what early involvement really means… it is in my mind NLPHL or not). They had 93 patients with PTGC who never developed a lymphoma, 23 patients with synchronous PTGC and NLPHL, and 44 patients with PTGC with antecedent or subsequent history of lymphoma.…”