Nodular lymphocyte predominant Hodgkin's disease progressing to a large B-cell lymphoma without previous treatment

The nodular form of lymphocyte predominance Hodgkin's disease presents particular clinical and biological features that have set it apart as a distinct clinicopathological entity. It has an indolent course with long-term survival despite frequent localized relapses, and a remarkable tendency to progress into a B-cell non-Hodgkin's lymphoma. Biological evidence strongly point to a B-cell proliferation from the start. We report the unique case of a patient with nodular lymphocyte predominant Hodgkin's disease in stage I who had all disease removed for diagnosis and did not receive fu;ther treatment. He relapsed in the same lymph node area twelve years later, and the biopsy was now consistent with a large B-cell lymphoma. The histopathological and immunophenotypic profiles clearly show the identity of the two lymph node proliferations. This phenomenon exemplifies the growing inter-relashionship between Hodgkin's disease and non-Hodgkin's lymphomas.