title: Lymphocyte predominance Hodgkin's disease. Evidence for a kappa light chain-restricted monotypic B-cell neoplasm.
abstract: Over the last decade, it has been noted that nodular lymphocytic and/or histiocytic predominance Hodgkin's disease (NLPHD) has clinical, histological, and immunophenotypical differences from classical Hodgkin's disease, but it is not clear whether NLPHD represents a B-cell neoplasm or merely an unusual B-lineage reactive condition. We evaluated 36 cases of LPHD (31 nodular, 5 diffuse) for evidence of B-cell clonality by immunohistochemistry for light-chain protein using polyclonal antibodies and microwave antigen retrieval, and by a highly sensitive in situ hybridization technique for light-chain mRNA using 3H-labeled antisense RNA probes. We found monotypic light-chain restriction for kappa protein in 36% of cases, with no clear predominance for either light-chain protein in the other cases. By in situ hybridization, 80% of the evaluable cases showed clear evidence of light-chain monotypsim, with 96% of cases monotypic for kappa mRNA and one case monotypic for lambda mRNA. In virtually all of these cases, the L&H cells were found to be monotypic, consistent with monoclonality. In about one-half of these cases, a small lymphocytic component was also found to be monotypic. Our data support the hypothesis that NLPHD and its rare diffuse variant represent a monotypic B-cell neoplasm, almost always of kappa light-chain type. NLPHD represents a neoplasm distinct from classical Hodgkin's disease.
authors.affiliation: Department of Pathology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Stoler
authors.forename: G E
authors.initials: GE
authors.lastname: Nichols
authors.forename: M
authors.initials: M
authors.lastname: Symbula
authors.forename: L M
authors.initials: LM
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D012334:RNA, Neoplasm / Q000032:analysis; D012189:Retrospective Studies
chemical_list: D007145:Immunoglobulin kappa-Chains; D012333:RNA, Messenger; D012334:RNA, Neoplasm