Untanu RV, et al. – This report explored the histologic and immunophenotypic variants for pediatric nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). Investigations revealed that variant histology was common in pediatric NLPHL, especially types C and E, which were associated with immunoglobulin D (IgD) expression. Type C variant histology and possibly type D were associated with decreased event–free survival (EFS), but neither IgD nor CD30 was the adverse feature.

Methods

• In this study, 168 cases of localized NLPHL were examined for histologic variants, CD30 and immunoglobulin D (IgD) expression, and outcome.
• Histologic types were scored categorically as 0 = 0, 1 ≤ 25%, and 2 > 25% of the sample.

Results

• 58 (35.1%) cases showed only typical nodular with or without serpiginous histology (types A and B).
• The remainder showed mixtures of histologies.
• The numbers of patients with score 2 were 85 (50.6%) type A, 21 (12.5%) type B, 46 (27.4%) with extranodular large B cells (type C), 3 with T–cell–rich nodular pattern (type D), 55 (32.7%) with diffuse T–cell–rich (type E) pattern, and 2 (1.2%) with diffuse B–cell pattern (type F).
• Higher level of types C (P = 0.048) and D (P = 0.033) resulted in lower event–free survival (EFS).
• Cytoplasmic IgD was found in 65 of 130 tested (50%), did not significantly associate with EFS but positively correlated with types C and E histology (P < 0.0001) and negatively correlated with types A (P = 0.0003) and B (P = 0.006).
• 17 (10%) expressed CD30, with no adverse effect.