Recurrent Nodular Lymphocyte Predominant Hodgkin Lymphoma with Diagnostic Evolution Over Two Decades
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VDJ-Seq: Deep Sequencing Analysis of Rearranged Immunoglobulin Heavy Chain Gene to Reveal Clonal Evolution Patterns of B Cell Lymphoma
Published on: December 28, 2015
Swetha Atluri1, Fred Schiffman2
1Department of Internal Medicine, Brown University Health, Providence, RI.
Abstract:
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma with distinct pathologic and clinical characteristics. We present the case of a 51-year-old man with a nearly 20-year history of NLPHL characterized by multiple relapses, diagnostic reclassification, and treatment de-escalation. This case illustrates the diagnostic challenges in distinguishing NLPHL from lymphocyte-rich classical Hodg- kin lymphoma (LRCHL), the indolent natural history of NLPHL with prolonged remissions, and the role of active surveillance in managing asymptomatic relapsed disease.
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