Hodgkin lymphoma: differences and differential diagnosis
Abstract
Hodgkin lymphoma accounts for approximately 15% of all lymphomas. The World Health Organization 2017 classification lists two main types as separate entities: classic Hodgkin lymphoma and nodular lymphocyte predominant Hodgkin lymphoma (NLPHL).
The morphology of neoplastic cells differs slightly in both types, while these cells in typical cases show a different immunophenotype. Overlapping histological images and immunophenotypes cause diagnostic difficulties and the need for detailed differential analysis. The classic form accounts for about 90% of cases and occurs in four histoclinical subtypes, requires differentiation from other lymphomas and immunoproliferation, and neoplasms with other differentiation. NLPHL occurs in six immunohistochemical patterns. An increase in the number of T lymphocytes and histiocytes, and a disappearance of the nodular structure, are associated with a more aggressive course and the possibility of transformation into diffuse large B-cell lymphoma, most often T-cell/histiocyte rich large B-cell lymphoma. Recent reports demonstrate the importance of stroma in maintaining tumor viability. Accurate histopathological diagnosis must be based on representative material that allows the assessment of the architecture of the tissue.
Keywords: classic Hodgkin lymphomanodular lymphocyte predominant Hodgkin lymphomagray zone lymphoma
References
- Kass AM, Kass EH. Perfecting the world: the life and times of Dr. Thomas Hodgkin 1798–1866. 1st ed. Harcourt Brace Jovanovich, Boston, San Diego, New York 1988.
- Aggarwal P, Limaiem F. Reed Sternberg Cells. National Center for Biotechnology Information. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK542333/ (April 21, 2021).
- Nagpal P, Descalzi-Montoya DB, Lodhi N. The circuitry of the tumor microenvironment in adult and pediatric Hodgkin lymphoma: cellular composition, cytokine profile, EBV, and exosomes. Cancer Rep (Hoboken). 2021; 4(2): e1311.
- Ferrarini I, Rigo A, Visco C, et al. The evolving knowledge on T and NK cells in classic hodgkin lymphoma: insights into novel subsets populating the immune microenvironment. Cancers (Basel). 2020; 12(12): 3757.
- Momotow J, Borchmann S, Eichenauer DA, et al. Hodgkin lymphoma-review on pathogenesis, diagnosis, current and future treatment approaches for adult patients. J Clin Med. 2021; 10(5): 1125.
- Swerdlow SH, Campo E, Harris NL. WHO classification of tumours pf haematopoietic and lymphoid tissues. Revised 4th ed. International Agency for Research on Cancer, Lyon 2017.
- Jaffe ES, Harris NL, Vardiman JW, Campo E, Arber DA. Hematopathology. 1st ed. Saunders, Saint Louis 2011.
- Hartmann S, Eichenauer DA. Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma. Pathology. 2020; 52(1): 142–153.
- Parente P, Zanelli M, Sanguedolce F, et al. Hodgkin Reed-Sternberg-like cells in non-Hodgkin lymphoma. Diagnostics (Basel). 2020; 10(12): 1019.
- Wang HW, Balakrishna JP, Pittaluga S, et al. Diagnosis of Hodgkin lymphoma in the modern era. Br J Haematol. 2019; 184(1): 45–59.
- Brune MM, Juskevicius D, Haslbauer J, et al. Genomic landscape of Hodgkin lymphoma. Cancers (Basel). 2021; 13(4): 682.
- Mottok A, Steidl C. Biology of classical Hodgkin lymphoma: implications for prognosis and novel therapies. Blood. 2018; 131(15): 1654–1665.
- Bienz M, Ramdani S, Knecht H. Molecular pathogenesis of Hodgkin lymphoma: past, present, future. Int J Mol Sci. 2020; 21(18): 6623.
- Zeng Q, Schwarz H. The role of trogocytosis in immune surveillance of Hodgkin lymphoma. Oncoimmunology. 2020; 9(1): 1781334.
- Murray PG, Young LS. An etiological role for the Epstein-Barr virus in the pathogenesis of classical Hodgkin lymphoma. Blood. 2019; 134(7): 591–596.
- Luo Y, Liu Y, Wang C, et al. Signaling pathways of EBV-induced oncogenesis. Cancer Cell Int. 2021; 21(1): 93.
- Leong MM, Lung MLi. The impact of Epstein-Barr virus infection on epigenetic regulation of host cell gene expression in epithelial and lymphocytic malignancies. Front Oncol. 2021; 11: 629780.
- Poppema S. Lymphocyte predominant Hodgkin lymphoma, antigen-driven after all? J Pathol. 2021; 253(1): 1–10.
- Boudová L, Torlakovic E, Delabie J, et al. Nodular lymphocyte-predominant Hodgkin lymphoma with nodules resembling T-cell/histiocyte-rich B-cell lymphoma: differential diagnosis between nodular lymphocyte-predominant Hodgkin lymphoma and T-cell/histiocyte-rich B-cell lymphoma. Blood. 2003; 102(10): 3753–3758.
