Klin Padiatr 2014; 226 - O_12
DOI: 10.1055/s-0034-1371129

Variant Histological Patterns of Nodular Lymphocyte Predominant Hodgkin Lymphoma in Children Treated in Trials of the GPOH-HD

S Hartmann 1, C Mauz-Körholz 2, D Eichenauer 3, A Mottok 4, R Bob 5, K Koch 6, HW Bernd 7, S Cogliatti 8, M Hummel 9, A Feller 7, G Ott 10, P Möller 11, A Rosenwald 4, H Stein 5, ML Hansmann 1, D Körholz 2, W Klapper 6
  • 1Goethe University, Pathology, Frankfurt, Germany
  • 2University Hospital Halle, Halle, Germany
  • 3German Hodgkin Study Group, Cologne, Germany
  • 4University of Würzburg, Würzburg, Germany
  • 5Pathodiagnostic, Berlin, Germany
  • 6University Schleswig-Holstein, Kiel, Germany
  • 7University Schleswig-Holstein, Lübeck, Germany
  • 8Kantonsspital, St. Gallen, Switzerland
  • 9Charité University Hospital, Berlin, Germany
  • 10Robert-Bosch-Krankenhaus, Stuttgart, Germany
  • 11University Hospital, Ulm, Germany

Question: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) predominantly affects middle aged men and generally shows a favourable clinical course. However, also children can be affected by this rare subtype of Hodgkin lymphoma. NLPHL can show a typical nodular or variant histopathologic growth pattern. Some of the histological variants mimic T-cell/histiocyte-rich-large B-cell Lymphoma (THRLBCL). Recently, we showed that histopathologic variants of NLPHL more frequently present in advanced clinical stages and have an increased risk of relapse in adults.

Methods: In order to determine if this holds true also for pediatric NLPHL, 91 pediatric NLPHL cases enrolled in clinical studies/registries GPOH-HD2002, LPHL-Interim and EuroNet-PHL-LP1 were reviewed for histological growth patterns.

Results: Compared to adult NLPHL, histopathologic variant patterns were observed more frequently in children, particularly with a prominent extranodular localization of the LP cells. However, in contrast to adult patients differences in clinical behavior could not be demonstrated so far.

Conclusions: Due to their morophogical similarity to THRLBCL, histological variants of NLPHL in children might pose a diagnostic pitfall. However, in contrast to adults, these variants are not associated with inferior outcome compared to typical NLPHL and might be sufficiently treated with the therapy regiment provided for this entity.