AUTHORITY TALK: What is Hodgkin’s Lymphoma?

The text is about Nodular Lymphocyte Predominant HL (NLPHL). This type would have initially been placed in the classical HL lymphocyte-rich subtype, and was later named separately as more research revealed some cases with unique pathologic and clinical features. Knowing its origin, one understands why the two are morphologically similar, and their differences can be easily remembered in differential diagnosis. The incidence of NLPHL is actually not very high, reported to be about 3-8% of HL in the Western literature, and is said to be even rarer in China, but it is more likely that it is not well known and missed. In view of this, we put NLPHL in the first part of the HL section to be explained. 1. Epidemiology: the median age of onset is 40th, and males are more common, which is different from the subtype of tuberous sclerosis that has the highest proportion in classic HL (please remember this point, so that it will be memorized by comparing it with the classic HL when it is explained). 2. Arrangement: Since it is called nodular lymphocyte predominant type, of course it is arranged in a nodular pattern, but the fact is that although most of them are so, there are other histological patterns, which are briefly described as follows: (1) classical B nodular type, the most common; (2) creeping nodular type: that is to say, the nodules are irregular; (3) a large number of LP tumor cells can be seen outside of the nodules (we will introduce the term in a while); (4) T nodular type; (5) rich nodular type; (7) lymphocytes in the nodules; (8) lymphocytes in the nodules. nodular type; (5) T/histiocyte-rich LBCL type; (6) B-cell-rich diffuse type. In order to facilitate your search, these arrangements are listed here, if the content of this area is not familiar with the headache of friends can first master the most common tissue forms. 3. Characteristics of tumor cells: do not have to shiver, most of the ‘popcorn-like’, the nucleus is a little larger than the central mother cell, lobulated, due to the fact that most often seen in the NHLHL is also known as LP cells. So experienced hematopathologists can initially determine the diagnosis of NLPHL by virtue of the way the tissues are arranged and the characteristics of LP cells, but it is worth mentioning that not all tumor cells in NLPHL are LP cells, and classical RS cells can also be seen. 4. Background: The background of NLPHL is also different, unlike the classic HL background which is so complex and varied, but is dominated by lymphocytes and histiocytes, sometimes surrounded by a ring of cytoplasmic epithelioid histiocytes around the nodule, which appears to have a ‘worm-eaten’ appearance at low magnification. Tumorigenic LP cells are often ‘hidden’ among these histiocytes, so it is important to look carefully for LP cells to make a correct diagnosis.