A male patient 59 year old complains of multiple swellings in the neck, fever, and weight loss since 6 months. Patient is a known hypertensive and is on medication for the same. General examination reveals painless lymph node enlargement in the neck and on blood investigation, anemia is revealed. Lymph node biopsy shows cells that have a delicate multilobed, puffy nucleus resembling popped corn. Which variant of lymphoma is this?
Lymphocyte-predominant Hodgkin lymphoma, accounting for about 5% of cases, is characterized by the presence of lymphohistiocytic (L&H) variant RS cells that have a delicate multilobed, puffy nucleus resembling popped corn (“popcorn cell”). L&H variants usually are found within large nodules containing mainly small B cells admixed with variable numbers of macrophages. Other reactive cells, such as eosinophils, are scanty or absent, and typical RS cells are rare.
Unlike the RS variants in “classical” Hodgkin lymphoma, L&H variants express B cell markers (e.g., CD20) and usually fail to express CD15 and CD30. Most patients present with isolated cervical or axillary lymphadenopathy, and the prognosis typically is excellent.
Nodular sclerosis
Lymphocyte rich
Lymphocyte depletion
Lymphocyte predominant