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EBV-positive nodular lymphocyte predominant Hodgkin lymphoma: a single institution experience

Fei Fei1, Kala Gnanasekaran Kiruthiga2, Sheren Younes1

  • 1Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA.

Human Pathology
|August 20, 2022
PubMed

Insights

Epstein-Barr virus (EBV)-positive nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is rare and can be challenging to diagnose due to atypical features. Strong CD20 and OCT2 expression in LP cells supports the diagnosis.

Area of Science:

  • Hematology
  • Oncology
  • Virology

Background:

  • Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a distinct subtype of Hodgkin lymphoma.
  • The role of Epstein-Barr virus (EBV) in NLPHL pathogenesis is not fully understood.
  • Characterizing EBV-positive NLPHL is crucial for accurate diagnosis and understanding disease biology.

Observation:

  • This study analyzed 17 cases of EBV-positive NLPHL.
  • EBV was detected in lymphocyte predominant (LP) cells in 6 cases and background cells in others.
  • LP cells showed strong CD20 and OCT2 expression, but variable PAX5 and CD79a.
  • Partial CD30 expression was observed in some cases.

Findings:

  • EBV-positive NLPHL is a rare entity.
  • Atypical immunophenotypic features, including variable PAX5/CD79a and partial CD30 expression, can complicate diagnosis.
  • Retention of B-cell phenotype markers (CD20, OCT2) is key for diagnosis.
  • A case of recurrent EBV-positive NLPHL with NF-kB pathway involvement was noted.

Implications:

  • Accurate identification of EBV-positive NLPHL is essential for appropriate patient management.
  • Understanding the diagnostic challenges can improve diagnostic accuracy.
  • Further research into the role of EBV in NLPHL may reveal therapeutic targets.

Keywords:
Epstein–Barr virusHodgkin lymphomaNodular lymphocyte predominant Hodgkin lymphoma

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