Shankar Anand1, Akshatha C.2, Libin Babu Cherian3, C. Ramachandra4 1,
BACKGROUND
The term Hodgkin’s lymphoma includes classical Hodgkin lymphoma (CHL) and
the less common nodular lymphocyte predominant Hodgkin lymphoma (NLPHL).
NLPHL is a B cell neoplasm usually characterised by nodular or follicular and diffuse
proliferation of small lymphocytes with single scattered large neoplastic cells
(LP/L&H/Popcorn cells). NLPHL accounts for 10 % of all Hodgkin lymphoma.
METHODS
This is a retrospective study. Histopathology slides and blocks of 24 cases of
nodular lymphocyte predominant Hodgkin lymphoma were collected from the
archives of histopathology from 2011 to 2015. The immunohistochemistry slides
of the corresponding histopathology cases were also assembled. Both the slides
were reviewed by three expert onco-pathologists and IHC markers were studied
and compared.
RESULTS
Patients were mostly young between 20 and 40 years (16 / 24, 66.67 %). There
was a distinct male preponderance (20 / 24, 83.3 %). Most cases involved cervical,
axillary or inguinal lymph nodes, with cervical lymph nodes being the most
common (13 / 24, 54 %). It was found that CD45, CD20, CD79a and PAX5 staining
highlighted the LP cells in all twenty-four cases, while OCT - 2 and BOB - 1 were
highlighted in twenty-three cases (95.8 %), which was statistically significant. CD3
and CD5 IHC staining on T cell rosettes and background reactive T cells were
examined, and it was seen that CD3 expression was far more consistent than CD5
expression in T cell rosettes and reactive T cells. Also, it was seen that, those
cases which were double positive for CD3 and CD5 constitutes only eight cases (8
/ 24, 33.3 %).
CONCLUSIONS
CD3 is a more consistent marker than CD5 in demonstrating surrounding reactive
T cells in NLPHL. CD45, PAX5, CD20, BOB - 1 and OCT - 2 are consistent
immunohistochemical markers of LP cells.
