title: Diffuse large B cell lymphoma derived from nodular lymphocyte predominant Hodgkin lymphoma presents with variable histopathology.
abstract: BACKGROUND
  Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) usually presents in middle aged men and shows an indolent clinical behavior. However, up to 30% of the patients present a secondary transformation into aggressive diffuse large B cell lymphoma (DLBCL). The aim of the present study was to characterize morphology and immunophenotype of this kind of DLBCL in detail and compare it with conventional DLBCL.
  
  
  METHODS
  Morphology and immunophenotype of 33 cases of NLPHL with simultaneous or sequential transformation into DLBCL were investigated. These cases were compared with 41 de novo DLBCL in Finnish men.
  
  
  RESULTS
  The majority of cases exhibited different immunophenotypes in the NLPHL and the DLBCL components. The immunophenotype of the DLBCL secondary to NLPHL was heterogeneous. However, BCL6, EMA, CD75 and J-chain were usually expressed in both components (≥73% positive). Overall, the NLPHL component was more frequently positive for EMA, CD75 and J-chain than the DLBCL component. In contrast, B cell markers, CD10 and BCL2, were more frequently expressed and were expressed at higher levels in the DLBCL component than in the NLPHL component. In the independent series of de novo DLBCL 4 cases could be identified with a growth pattern and immunophenotype that suggested that they had arisen secondarily from NLPHL.
  
  
  CONCLUSIONS
  The morphology and immunophenotype of DLBCL arisen from NLPHL is heterogeneous. Further characterization of the particular molecular features of this subgroup is warranted to be able to better identify these cases among conventional DLBCL.
authors.affiliation: Dr, Senckenberg Institute of Pathology, Hospital of the Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main D- 60590, Germany. s.hartmann@em.uni-frankfurt.de.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hartmann
authors.forename: Mine
authors.initials: M
authors.lastname: Eray
authors.forename: Claudia
authors.initials: C
authors.lastname: Döring
authors.forename: Tuula
authors.initials: T
authors.lastname: Lehtinen
authors.forename: Uta
authors.initials: U
authors.lastname: Brunnberg
authors.forename: Paula
authors.initials: P
authors.lastname: Kujala
authors.forename: Martine
authors.initials: M
authors.lastname: Vornanen
authors.forename: Martin-Leo
authors.initials: ML
authors.lastname: Hansmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D049109:Cell Proliferation; D018450:Disease Progression; D018572:Disease-Free Survival; D005387:Finland; D006689:Hodgkin Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology*; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology*; D008224:Lymphoma, Follicular / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor