IMMUNO-ARCHITECTURAL PATTERN ANALYSIS IN NODULAR LYMPHOCYTE PREDOMINANT HODGKIN LYMPHOMA – A RETROSPECTIVE ANALYSIS OF 14 CASES

Background: Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) is an uncommon subtype of Hodgkin Lymphoma associated with an indolent course. NLPHL has distinct clinical features, histological, immunohistochemical and gene expression profile when compared to Classic Hodgkin Lymphoma, and the recent World Health Organization - Hematolymphoid tumors V edition, suggests a nomenclature change to Nodular Lymphocyte Predominant B Cell Lymphoma as it appears more related to the mature B cell Non-Hodgkin Lymphoma. Various Immunoarchitectural patterns (A to F) have been described of which patterns C to F are called as variant patterns and these patterns are associated with disease recurrence and progression. This study is a retrospective and descriptive analysis of Materials And Methods: 16 lymph node biopsies from 14 patients of NLPHL diagnosed over a period of five years. Haematoxylin and Eosin-stained sections, along with CD3 and CD20 immunohistochemistry, amongst others, were used to assess the immuno-architectural patterns. Pattern Results: A was seen in five, followed by pattern C and E in four patients each. The remaining patient had pattern B. During the period of study, two patients had recurrence. The recurrent cases had pattern C and pattern E respectively at diagnosis and during recurrence both showed pattern E. This study reaf Conclusion: firms the importance of recognizing the immuno-architectural patterns in NLPHL, with variant patterns being associated with disease recurrence. Hence, it is necessary that the hematopathologist reporting on a case of NLPHL should be aware of the patterns and report on the immuno-architectural pattern accordingly.