Criteria useful in the differential diagnosis between nodular LPHD and LRCHD
| . | NLPHD . | NLRCHD . |
|---|---|---|
| Reactive background | ||
| Conventional histology | ||
| Nodules composed of small lymphoid cells | + | + |
| Atrophic or intact germinal centers in affected regions | − | + (eccentrically placed) |
| Epithelioid cell aggregates | + | +/− |
| Absence of granulocytes | + | + |
| Fine sclerotic bands surrounding nodules | −/+ | −/+ |
| Immunohistology | ||
| Nodules composed of B cells | + | + |
| CD57+ T cells | + | −/+ |
| CD57+ cells forming rosettes | + | − |
| CD3+ cells forming rosettes | + | + |
| CD21+ FDC meshworks | Expanded meshwork | Condensed in atrophic GC, expanded in mantle zone |
| Neoplastic cells | ||
| Morphology | ||
| L&H (popcorn) cell | + | +/− |
| Classic RS cell | −/+ | + |
| Immunohistology | ||
| CD20 | + (98%) | −/+ (32.5%) |
| CD79a | + (80%) | −/+ (8.7%) |
| J-chain | + (91.5%) | − (0%) |
| CD30 | − (0%) | + (92.5%) |
| CD15 | − (0%) | 0.81 |
| EMA | +/− (54%) | −/+ (2.5%) |
| EBER-transcripts | 0% | 41% |
| . | NLPHD . | NLRCHD . |
|---|---|---|
| Reactive background | ||
| Conventional histology | ||
| Nodules composed of small lymphoid cells | + | + |
| Atrophic or intact germinal centers in affected regions | − | + (eccentrically placed) |
| Epithelioid cell aggregates | + | +/− |
| Absence of granulocytes | + | + |
| Fine sclerotic bands surrounding nodules | −/+ | −/+ |
| Immunohistology | ||
| Nodules composed of B cells | + | + |
| CD57+ T cells | + | −/+ |
| CD57+ cells forming rosettes | + | − |
| CD3+ cells forming rosettes | + | + |
| CD21+ FDC meshworks | Expanded meshwork | Condensed in atrophic GC, expanded in mantle zone |
| Neoplastic cells | ||
| Morphology | ||
| L&H (popcorn) cell | + | +/− |
| Classic RS cell | −/+ | + |
| Immunohistology | ||
| CD20 | + (98%) | −/+ (32.5%) |
| CD79a | + (80%) | −/+ (8.7%) |
| J-chain | + (91.5%) | − (0%) |
| CD30 | − (0%) | + (92.5%) |
| CD15 | − (0%) | 0.81 |
| EMA | +/− (54%) | −/+ (2.5%) |
| EBER-transcripts | 0% | 41% |
LPHD, lymphocyte predominance Hodgkin disease; LRCHD, lymphocyte-rich classical Hodgkin disease; NLPHD; nodular lymphocyte predominance Hodgkin disease; NLRCHD, nodular lymphocyte-rich classical Hodgkin disease; EMA, epithelial membrane antigen; EBER, Epstein-Barr–encoded RNA.