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Blood, 1 September 2000, Vol. 96, No. 5, pp. 1889-1899
NEOPLASIA
European Task Force on Lymphoma project on lymphocyte
predominance Hodgkin disease: histologic and immunohistologic analysis
of submitted cases reveals 2 types of Hodgkin disease with a
nodular growth pattern and abundant lymphocytes
Ioannis Anagnostopoulos,
Martin-Leo Hansmann,
Kaarle Franssila,
Martin Harris,
Nancy L. Harris,
Elaine S. Jaffe,
J. Han,
J. M. van Krieken,
Sibrand Poppema,
Teresa Marafioti,
Jeremy Franklin,
Michael Sextro,
Volker Diehl, and
Harald Stein on behalf of the European Task Force on
Lymphoma
From the Institute of Pathology, Klinikum Benjamin
Franklin, Free University Berlin, Berlin, Germany; Senkenbergisches
Center for Pathology, University of Frankfurt, Frankfurt, Germany;
Department of Pathology, Helsinki University Central Hospital,
Helsinki, Finland; Department of Pathology, Christie Hospital,
Manchester, England; Department of Pathology, Massachusetts General
Hospital, Boston MA; National Cancer Institute, Bethesda, MD;
Department of Pathology, University Medical Center, Nijmegen, The
Netherlands; Department of Pathology Faculty of Medical Sciences,
University of Groningen, Groningen, The Netherlands; and the First
Clinic for Internal Medicine, University of Cologne, Cologne, Germany.
Paraffin blocks and clinical data from 521 patients with lymphocyte
predominance Hodgkin disease (LPHD) diagnosed between 1970 and 1994 were collected from 16 European and United States oncological
centers to establish the pathologic and clinical characteristics of a large patient cohort, to determine how frequent T-cell-rich large
B-cell lymphoma (TCRLBCL) is among LPHD, and to find
differential diagnostic criteria distinguishing between the 2 lymphoma
categories. For this purpose, conventionally and immunohistologically
stained sections were reviewed by a panel of hematopathologists. The
diagnosis of LPHD was confirmed in only 219 of the 388 assessable cases (56.5%). This low confirmation rate was due
mainly to the presence of a new variant of classical Hodgkin disease
(CHD), which resembled, in terms of nodular growth and
lymphocyte-richness, nodular LPHD and, in terms of the immunophenotype
of the tumor cells, CHD and was designated nodular
lymphocyte-rich CHD (NLRCHD). The nodules of LRCHD consisted as
in nodular LPHDpredominantly of B cells but differed from those
present in LPHD in that they represented expanded mantle zones
with atrophic germinal centers. Clinically, patients with LPHD and
NLRCHD showed similar disease characteristics at presentation but
differed in the frequency of multiple relapses and prognosis after
relapse. Patients with LPHD and NLRCHD clearly differed from patients
with CHD with nodular sclerosis or mixed cellularity, as they presented
with an earlier disease stage and infrequent mediastinal involvement.
As 97% of the LPHD cases showed a complete or partial nodular growth
pattern, their differentiation from TCRLBCL was a rare problem in the
present series.
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