Nodular Lymphocyte Predominant Hodgkin Lymphoma

Lee, Alfred Ian; LaCasce, Ann S.

doi:10.1634/theoncologist.2009-0099

Cited by 61 publications

(47 citation statements)

References 87 publications

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“…According to a review an increased risk has been observed for secondary NHL in NLPHL patients with about 1-5% and molecular analysis of immunoglobulin heavy chain gene rearrangements indicates that some cases of the secondary NHL may share a common clonal origin with the primary NLPHL [16]. In our case, the TCRLBCL most (HE stain, 940).…”

Section: Discussionmentioning

confidence: 48%

Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma

et al. 2011

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A 32-year-old male patient was diagnosed with nodular lymphocyte-predominant Hodgkin lymphoma. Staging FDG PET-CT detected a large right axillary lymph node conglomerate and splenic manifestation. Interim PET-CT following two cycles of ABVD chemotherapy revealed good metabolic response with the exception of a single axillary lymph node. A second ''interim'' PET-CT after two further cycles showed a similar result. A biopsy of the metabolically active non-palpable lymph node was performed using radioguided occult lesion localization (ROLL) with ultrasound guidance. The lymph node was successfully removed by minimally invasive surgery. Histological evaluation of the lymph node revealed a T cell-rich diffuse large B cell lymphoma. Based on this finding, a more aggressive treatment regimen followed by high dose chemotherapy with autologous stem cell rescue was adopted. To our knowledge, this is the first report of a lymphoma case in which the ROLL method was used in the radioguided biopsy of a chemoresistant lymph node detected by interim FDG PET-CT.

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Section: Discussionmentioning

confidence: 48%

Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma

et al. 2011

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“…Compared with classical HL, NLPHL shows a slightly older median age at presentation (30-40 years), greater male predominance (3:1), less mediastinal involvement (<15%), greater representation of limited stage disease (70%-80%), lower occurrence of cHL risk factors [9] and less aggressive tumor growth [22,23]. When diagnosed and treated in early favorable stages, NLPHL is associated with an excellent prognosis [19], with response rates to primary therapy exceeding 90% [9] and complete remission (CR) rates exceeding 95% [10].…”

Section: Discussionmentioning

confidence: 97%

“…When diagnosed and treated in early favorable stages, NLPHL is associated with an excellent prognosis [19], with response rates to primary therapy exceeding 90% [9] and complete remission (CR) rates exceeding 95% [10]. However, progression to DLBCL-like lesions has been reported in approximately 3-5% of cases [18].…”

Section: Discussionmentioning

confidence: 99%

“…Extranodal disease in NLPHL is rarely observed, with the exception of splenic involvement, which can be seen in 10%-15% of cases. Liver involvement occurs in <10% of patients, and bone marrow or lung infiltration is found in <5% [9].…”

Section: Discussionmentioning

confidence: 99%

“…When diagnosed in early favorable stages, NLPHL is associated with an excellent prognosis, [9,10]. Although NLPHL has been reported involving Waldeyer's ring [11], most of the previous studies were performed before the advent of immunohistochemical analysis and lack confirmatory immunophenotypic data.…”

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confidence: 99%

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Nodular lymphocyte-predominant Hodgkin lymphoma of the tonsil: a case study using immunohistochemistry and FISH analysis and review of the literature

Ιωάννου

Kouvaras

Gletsou³

et al. 2011

J Hematopathol

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Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma that differs from classic Hodgkin lymphoma with respect to histological and clinical presentations. This type of lymphoma typically affects predictable lymph node groups with excellent treatment outcomes. However, rare atypical locations have also been described and a possible diverse clinical or biological subtype has been suggested. We present a case of NLPHL arising in the tonsil of a 43-year-old man. The patient presented with a submucosal mass in an asymmetrically enlarged tonsil. Bilateral tonsillectomy was performed and histological examination showed effacement of the enlarged tonsil by nodules comprised of scattered large atypical cells having classic lymphocyte-predominant cell morphology in a background of benign B cells. Immunohistochemical analysis showed lack of CD15 and CD30 in the LP cells and strong expression of CD20, CD45, BCL-6 and epithelial membrane antigen (EMA). Interphase fluorescence in situ hybridization (FISH) analysis, revealed bcl-6 gene rearrangement in the LP cells. Although lymphoma is a common malignancy of the tonsil, there are only sporadic reports of NLPHL arising in this location and the differential diagnosis should include this entity. Histological, immunohistochemical and FISH findings are also discussed and the literature reviewed.

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Adult nodular lymphocyte‐predominant Hodgkin lymphoma: treatment modality utilization and survival

et al. 2018

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Early‐stage nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) is associated with a favorable prognosis. Our aim was to evaluate the patterns of care of radiotherapy utilization in this disease and to define the relationship between treatment modality and survival. The National Cancer Database was queried for patients with stages I‐II NLPHL diagnosed from 2004 to 2012. Patients were compared based on primary therapy into four categories: radiotherapy, chemotherapy, both, or neither. Covariate‐adjusted and propensity score‐weighted (PS) Cox proportional hazards models were used, adjusting for potential factors confounding survival. After exclusions, 1420 patients were evaluated, 571 (40%) received radiotherapy alone, 318 (22%) received chemotherapy alone, 351 (25%) received both, and 180 (13%) received neither. Younger patient age (P = 0.001), female gender (P = 0.019), and chemotherapy use (P < 0.001) were associated with decreased radiotherapy utilization. On PS, radiation alone (HR = 0.298, P < 0.001) and chemoradiotherapy (HR = 0.258, P < 0.001) were associated with improved survival compared to no upfront therapy, but the use of chemotherapy alone did not statistically differ compared to no initial therapy (HR = 0.784, P = 0.078). In this large database analysis, over one‐third of patients with early‐stage NLPHL did not receive radiotherapy as a component of initial therapy. The omission of upfront radiotherapy was associated with inferior survival.

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Nodular Lymphocyte Predominant Hodgkin Lymphoma

Abstract: ABSTRACT

Cited by 61 publications

References 87 publications

Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma

Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma

Nodular lymphocyte-predominant Hodgkin lymphoma of the tonsil: a case study using immunohistochemistry and FISH analysis and review of the literature

Adult nodular lymphocyte‐predominant Hodgkin lymphoma: treatment modality utilization and survival

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