Haema 2012; 3(3):298-306
by Flora N. Kontopidou, Theoni Kanellopoulou
Second Department of Internal Medicinec, National and Kapodistrian University of Athens, Ippokration General Hospital, Athens, Greece
Abstract
Nodular Lymphocyte-Predominant Hodgkin’s Lymphoma (NLPHL) is rare, accounting for approximately 5% of all Hodgkin’s lymphoma (HL) cases in Western countries. NLPHL and classical Hodgkin lymphoma (cHL) differ substantially in their histopathology, presenting features and clinical course. The neoplastic cell is the lymphocytic and histiocytic cell (LP cell), rather than the Reed–Sternberg (RS) cell of cHL. Unlike the RS cells, LP cells express both CD20 and CD45 (leukocyte common antigen) and are negative for CD15 and CD30. In comparison with cHL, NLPHL presents with a striking male predominance, while the disease is localized [Ann Arbor stages (AAS) I/II] in more than 80% of the patients and is rarely associated with B-symptoms and mediastinal involvement. Since this dis- ease is so uncommon, most information concerning treatment and outcome has come from reports of single institutions or pooled, multi-institutional retrospective analyses. As a result, treatment recommendations in NLPHL are diverse and range from noncurative options, such as watchful waiting or single- agent rituximab, through involved field radiation alone or combined modality therapy.