PMC8327231_01
Lymph node involvement by nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL)
showing prominent nodular growth pattern (hematoxylin and eosin, 100x magnification).
Inset is a high-magnification (400x) view of the characteristic cell of NLPHL, the
lymphocyte-predominant (LP) or "popcorn" cell. Note the polylobulated nucleus and small,
peripherally located nucleoli.
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Histopathology revealed effacement of the lymph node architecture by a nodular infiltrate predominantly consisting of small, non-neoplastic B-cell epithelioid histiocytes and intermingled lymphocyte-predominant (LP) cells (Figure 1).
Immunophenotypic characterization of lymphocyte-predominant (LP) cell (400x
magnification). The LP cell expresses CD20 (panel A) and CD45 (panel B) on the cell
surface but is negative for CD30 (panel C). The immunostain for CD3 (panel D) highlights
small, benign T-lymphocytes surrounding the LP and forming a characteristic rosette.
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B-cell-rich nodular type, as described by Fan et al.   The immunophenotype of the neoplastic cells was CD45+, CD20+, and CD30- which is typical for NLPHL (Figure 2). Because of the patient's young age and unusual presentation, the flow cytometry results and histopathological slides were reviewed and confirmed by expert hematopathologists at Massachusetts General Hospital and Boston Children's Hospital.