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We constructed tissue microarrays from formalin-fixed, paraffin-embedded tissue including 42 cases of cHL, 33 cases of NLPHL, 16 cases of anaplastic large cell lymphoma, and 7 cases of T-cell/ histiocyte-rich large B-cell lymphoma.
In NLPHL, the neoplastic cells (L and H cells) are of B-cell type; however, they are clearly different from H/R-S cells of classical HL.
Treatment of NLPHL and THRLBCL as individual entities in the relapsed refractory setting is challenging.
In prior reports, anywhere between 16 and 35% of PTGC are associated with NLPHL [7, 9, 10].
These immunophenotypic findings confirmed the diagnosis of NLPHL.
Their study showed that HRS cells in CHL, as well as NLPHL, originate from the germinal center (GC) B cells in most cases, if not all.
Of the 50 FFPE tissue blocks evaluated, 43 (86%) were cHL and 7 (14%) were NLPHL. CHL consisted of 8 (19%) cases with nodular sclerosis (NS), 10 (23%) cases with mixed cellularity (MC), one (2%) case with lymphocyte depletion (LD) and 24 (56%) of cases cHL sub-types of the which were not determined to.
The findings were consistent with coexistence of NLPHL and KS in the same lymph node.
Histologically, NLPHL is characterized by effacement of the normal lymph node architecture by an atypical cellular proliferation in a nodular and variably diffuse pattern.
of Patients % Patients % CD15 (+ve) 2 40 3 100 CD30 (+ve) 5 100 3 100 CD45 (-ve) 5 100 3 100 CD20 (+ve) 0 0 0 0 Table 4: Comparison of HL Subtypes between 4 Studies HL Subtypes Our Study Yildirim et al (7) NLPHL 0 cases 7 cases (2.1%) NS-cHL 15 cases (50%) 173 cases (52.7%) MC-cHL 5 cases (16.7%) 107 cases (32.5%) LR-cHL 3 cases (10%) 28 cases (8.5%) LD-cHL 5 cases (16.7%) 14 cases (4.2%) cHL-core biopsy 2 cases (6.7%) 0 cases Shimabukuro HL Subtypes V A et al (8) Rana et al (9) NLPHL 145 cases (5%) 0 cases NS-cHL 1668 cases (63%) 17 cases (16.34%) MC-cHL 731 cases (27%) 60 cases (57.69%) LR-cHL 100 cases (4%) 17 cases (16.34%) LD-cHL 23 cases (1%) 10 cases (9.62%) cHL-core biopsy 0 cases 0 cases
In these circumstances, the differential diagnosis is biased toward CHL, NLPHL, TCHRLBCL, gray zone lymphomas, BCLUWFIBDLBCLACHL, and in some cases, anaplastic large cell lymphoma.
Especially when florid or prominent, PTGCs maintain a nebulous relationship with NLPHL. Nodular lymphocyte-predominant Hodgkin lymphoma may occur in up to 15% to 20% of patients with notable PTGCs and may precede, coexist with, or follow the latter diagnosis.
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