Nodular Lymphocyte Predominant Hodgkin Lymphoma: A Rare Subtype with Distinct Clinicopathological Features

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma (HL) characterized by a distinct morphology, an older median age at onset, less incidence of mediastinal involvement, more frequent relapse and better prognosis as compared to Classical-HL (CHL). In contrast to CHL, the tumor cell (LP cell) of NLPHL almost always retains its B cell phenotype and is a CD30 non-expresser. Due to its rarity, only a handful of studies on this entity are available in the literature. We present a short case series of 10 cases of NLPHL diagnosed in our institute over 10 years. A total of 10 cases of NLPHL were retrospectively accessed, re-evaluated and classified further, based on various morphological patterns and immunophenotypic expression. Morphological patterns were correlated with overall the prognosis. Our study showed peripheral lymph node localization and overall good outcome in these cases. We also came across two unique cases, one was of NLPHL with Rosai-Dorfman disease (RDD) and another was of composite lymphoma showing components of NLPHL and Diffuse Large B cell Lymphoma (DLBCL).