The distinction of Hodgkin's disease from B cell lymphoma

Workshop C included cases with a differential diagnosis of Hodgkin's disease and B cell lymphoma. In general, the cases could be placed into one of the following four major categories: (1) usual Hodgkin's disease versus T cell-rich B cell lymphoma; (2) syncytial Hodgkin's disease versus B large cell lymphoma; (3) nodular and/or diffuse lymphocyte-predominance Hodgkin's disease (LPHD) versus T cell-rich B cell lymphoma; and (4) LPHD with composite or discordant large cell lymphoma versus T cell-rich B cell lymphoma progressing to large cell lymphoma. A final case illustrated the differential diagnosis of B cell Hodgkin's disease, ie, nodular LPHD versus the cellular phase of nodular sclerosing Hodgkin's disease (NSHD). The cases from this session have been grouped into these five categories and tables have been constructed to highlight features favoring each of the diagnostic possibilities. A brief discussion is given after each case, and selected cases have been illustrated to demonstrate some of the unusual histologic features.