THE MORPHOLOGICAL SUBSTRATE AND IMMUNOHYSTOARCHITECTURAL PATTERNS IN NODULAR LYMPHOCYTE PREDOMINANT HODGKIN LYMPHOMA

The aim of the study is to compare the tumour growth pattern with immunohystoarchitectural patterns in patients with nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) in the debut of the disease. 

Material and methods. The diagnosis of NLPHL in the debut of the disease was established in 60 patients (male/female ratio is 3.6:1, median age – 37 (range 17–68)) using morphology an expanded immunohistochemical study. The tumor growth pattern was determined by morphological study and immunohistochemical patterns (WHO 2017) – using antibodies to CD20 and clinical stages (Ann Arbor). 

Results and discussion. All patients were divided into 3 immunohystoarchitectural patterns (subject to immunohystoarchitectonics in reaction with antibodies to CD20): A – LP cells are located within B cell nodules; B – LP cells are located intra- and extranodular with the preservation of B cell nodules or in the presence of a border of B-lymphocytes; C – predominant (> 50 % of section area) diffuse or large-focal discrete arrangement of LP cells without the presence of a B cell border. Concerning to the immunohystoarchitectural patterns, all the patients were divided into three groups: I (immunohistochemical pattern A – 17 cases, 28 %, stage – I–II 82 %, stage III – 18 %, nodular growth – 100 %), II (immunohistochemical pattern B – 30 cases, 50 %, stage I–II – 40 %, stage III–IV – 60 %, nodular growth – 3 %, nodular growth with a significant number of extranodular LP cells – 43 %, nodular-diffuse growth – 53 % cases), III (immunohistochemical pattern C – 12 patients, 20 %; II stage – 8 %, tumor cell-rich case, stage III–IV – 92 %; nodular-diffuse growth – 75 % cases, mainly diffuse growth – 25 % cases), 1 case with transformation in DLBCL (2 %, IV stage). 

Conclusions. NLPHL is characterized by variable morphological immunohistochemical patterns among which we’ve revealed 4 morphological variants and 3 immunohistochemical patterns considered as sign of immunohistochemical transformation within the continuum of the same entity of NLHLP. The immunohistochemical patterns are not always a predictor of the clinical course of the disease. «Tumor cell-rich» cases require further detailed research.

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