[Nodular lymphocyte predominance Hodgkin's disease and its differential diagnosis].
Nodular lymphocyte predominance Hodgkin's disease (NLPHD), previously called nodular paragranuloma, is a rare entity recognized as a clinico-pathological entity distinct from classic Hodgkin's lymphoma. It is an indolent B cell lymphoma derived from a germinal center cell. NLPHD may closely resemble lymphocyte-rich classic Hodgkin's disease (LR-CHD) or T-cell or histiocyte-rich large B-cell lymphoma (TCRLBCL). A reproducible distinction between these entities is difficult but the classification is prognostically relevant. NLPHD is characterized by neoplastic "popcorn" cells CD20+ CD30- CD15- EMA+ Bcl6+ scattered within a nodular background predominantly composed of small B lymphocytes. LR-CHD neoplastic proliferation is composed of CD20+/- CD30+ CD15+/- EMA- Bcl6+/- Reed Sternberg or Hodgkin's cells, scattered within numerous CD3+ T cells. TCRLBCL is an agressive lymphoma composed of CD20+ CD30- CD15- EMA+/- Bcl6+/- polymorphic neoplastic cells, scattered within a mixture of CD3+ T cells and histiocytes. Epstein Barr virus is detectable within half cases of LR-CHD, but never in NLPHD and rarely in TCRLBCL. The transcription factors BOB1, PU-1, BSAP and IRF4 are new markers that could be useful for differential diagnosis.
Carbonnelle
Amélie
A
Service d'Anatomie et de Cytologie Pathologiques, UPRES EA 219 (Université Paris V), Paris.
Delarue
Richard
R
Canioni
Danielle
D
Brousse
Nicole
N
D015703:Antigens, CD / Q000032:analysis; D002471:Cell Transformation, Neoplastic; D003937:Diagnosis, Differential; D006689:Hodgkin Disease / Q000145:classification / Q000473:pathology*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*
D015703:Antigens, CD