Nodular lymphocyte-predominant Hodgkin lymphoma

Cytopathologic correlates on fine-needle aspiration

Authors

  • Andrea P. Subhawong MD,

    1. Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
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  • Syed Z. Ali MD,

    1. Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
    2. Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland
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  • Armanda D. Tatsas MD

    Corresponding author
    1. Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
    • Department of Pathology, The Johns Hopkins Hospital, 600 N Wolfe St, Pathology Building, Rm 406, Baltimore, MD 21287

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Abstract

BACKGROUND:

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), a rare subtype of Hodgkin lymphoma, is an indolent tumor with frequent instances of disease recurrence but a favorable prognosis. To the best of the authors' knowledge, there are only limited descriptions of NLPHL in the cytology literature because it was only formally recognized as a distinct entity in 1994.

METHODS:

In the current study, all cases of NLPHL diagnosed on excisional biopsy (n = 6 cases) at the study institution between 2000 and 2011 that had undergone previous fine-needle aspiration (FNA) were reviewed, with a focus on cytomorphologic features.

RESULTS:

Four of 6 cases were termed benign on FNA; however, there was retrospective recognition of characteristic LP cells in all cases. Unlike classical Hodgkin lymphoma, the tumor cells of NLPHL were often found to be mononucleate and presented in a background of small lymphocytes. Other features identified included epithelioid histiocytes and numerous bare atypical nuclei.

CONCLUSIONS:

Cases of NLPHL are commonly misdiagnosed as benign reactive lymphoid tissue and therefore a careful search using high magnification for LP cells is recommended in the evaluation of lymph node FNAs. Cancer (Cancer Cytopathol) 2012;. © 2012 American Cancer Society.

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