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
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