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Hodgkin lymphoma: differences and differential diagnosis
Affiliations- National Institute of Oncology, Institute of Research M. Sklodowska-Curie Memory, Krakow Branch, Poland
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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.
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 lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, gray zone lymphoma
About this articleTitle
Hodgkin lymphoma: differences and differential diagnosis
Journal
Issue
Article type
Review article
Pages
305-308
Published online
2021-08-31
Page views
169
Article views/downloads
635
DOI
10.5603/AHP.2021.0058
Bibliographic record
Acta Haematol Pol 2021;52(4):305-308.
Keywords
classic Hodgkin lymphoma
nodular lymphocyte predominant Hodgkin lymphoma
gray zone lymphoma
Authors
Andrzej Gruchała
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