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Follicular hodgkin lymphoma: a histopathologic study.

Rina Kansal1, Timothy P Singleton, Charles W Ross

  • 1Department of Pathology, University of Michigan, Ann Arbor 48109-0602, USA.

American Journal of Clinical Pathology
|January 16, 2002
PubMed
Summary

Follicular Hodgkin lymphoma (FHL) can mimic nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). Immunohistochemistry is crucial for distinguishing FHL from NLPHL, aiding accurate diagnosis and treatment.

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Area of Science:

  • Hematopathology
  • Oncology
  • Immunohistochemistry

Background:

  • Follicular Hodgkin lymphoma (FHL) presents morphologic similarities to nodular lymphocyte predominant Hodgkin lymphoma (NLPHL).
  • Accurate differentiation is critical for appropriate patient management.

Observation:

  • This study analyzed 13 cases of FHL, comparing their morphologic and immunohistochemical features with 40 NLPHL cases.
  • FHL cases exhibited follicles with small germinal centers (GCs) and mantle zones containing classic Reed-Sternberg (RS) cells.
  • Reactive GCs were present in 6 of 13 FHL cases.

Findings:

  • RS cells in FHL were consistently CD30+ and fascin+, with variable CD15 expression.
  • CD20 expression was noted in a subset of FHL cases, highlighting potential diagnostic challenges.

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  • Immunohistochemical analysis revealed key differences, including the presence of classic RS cells and a relative absence of histiocytes in FHL.

    • Implications:

    • Morphologic overlap between FHL and NLPHL necessitates immunohistochemical confirmation for definitive diagnosis.
    • Understanding these distinctions aids in precise classification and guides therapeutic strategies for Hodgkin lymphoma subtypes.