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Lymphocyte-Rich Classical Hodgkin Lymphoma
Lymphocyte-Rich Classic Hodgkin Lymphoma

Presentation

Most cases (80%) have mediastinal involvement present with stage II disease. [med-ed.virginia.edu]

They actually “look” more like B cells from an immunophenotypic standpoint: they are positive for CD20 (a B-cell marker), and negative for CD15 and CD30 (markers that are present on typical Reed-Sternberg cells). [pathologystudent.com]

[…] in subset of cases Histiocytes are present; relatively infrequent compared with lymphocytes Plasma cells uncommon or absent within nodules No eosinophils or neutrophils within nodules Loose follicular dendritic cell (FDC) meshworks underlying nodules [basicmedicalkey.com]

A 57-year-old male patient presented with neck masses. Neck computed tomography showed enlargement of multiple lymph nodes in right Level II and III. [ijpmonline.org]

Clinical signs, when present, are nocturnal sweating, itch, fever, weakness, cough or the mediastinal syndrome if the mediastinum is involved; corresponding patients are designed as B at the staging, or A when lymph nodal enlargement only are present [eurocytology.eu]

Immune System

  • Axillary Lymphadenopathy

    Most patients with NLP Hodgkin disease are young males (under 35 years of age) who present with cervical or axillary lymphadenopathy. In both NLP and LR Hodgkin lymphoma, though, the prognosis is good to excellent. [pathologystudent.com]

Face, Head & Neck

  • Neck Mass

    A 57-year-old male patient presented with neck masses. Neck computed tomography showed enlargement of multiple lymph nodes in right Level II and III. [ijpmonline.org]

Psychiatrical

  • Suggestibility

    […] effective immunologic strategy for the treatment of HL. [1] However, the observation of a higher number of PD-1 (+) lymphocytes in lymphocyte-rich cHL (LRCHL) and nodular lymphocyte predominant HL (NLPHL), which have better prognosis than other types, [2] suggests [ijpmonline.org]

    This picture may suggest a lymphocyte depletion. Extremely numerous CD30 positive RSH cell may suggest a lymphocyte depletion. [eurocytology.eu]

    There is a threefold increased risk of development of Hodgkin's disease in first-degree relatives, suggesting an unknown genetic mechanism. [medical-dictionary.thefreedictionary.com]

    Their presence also resembles the findings in classical Hodgkin's lymphoma, suggesting that mononuclear Hodgkin's cells and multinucleated Reed–Sternberg cells in lymphocyte-rich classical Hodgkin's lymphoma derive from germinal-center B-cells that silence [nature.com]

Neurologic

  • Meningism

    Complications as a result of the malignancy: Neurological symptoms such as headaches, changes in vision, or numbness of face Meningitis Anemia Intestinal blockage Kidney disease Bone marrow involvement (in very rare cases) Complications due to treatment [dovemed.com]

Treatment

Chapters discuss current treatment options—including combination chemotherapy, radiation therapy, novel treatment techniques, and hematopoietic stem cell transplantation—and offer guidelines for treatment selection. [books.google.com]

[…] may be used for diagnostic as well as for treatment purposes. [dovemed.com]

With modern risk-adjusted treatment, survival and relapse free survival are slightly better than the other subtypes of CHL. [seer.cancer.gov]

Radiotherapy, using a covering mantle to protect other organs, is the treatment of choice for early stages of the disease; combination chemotherapy is the treatment for advanced disease. [medical-dictionary.thefreedictionary.com]

American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/coping.html. Accessed July 27, 2017. [mayoclinic.org]

Prognosis

[…] than other types of classical Hodgkin lymphoma (95% complete remission rate, 17% relapse rate) Similar prognosis as NLPHL but relapses less frequently ( Blood 2000;96:1889 ) Microscopic (histologic) description Two growth patterns: nodular (common) and [pathologyoutlines.com]

Better prognosis Intermediate amongst the classical subtypes Worst amongst the classical subtypes Better prognosis Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) Please see next page Back to top Next [pedsoncologyeducation.com]

Treatment and prognosis Prognosis depends on stage as well as several other factors such as age, serological markers (ESR), presence of B symptoms, and histological tumor subtype: nodular lymphocyte predominant: best prognosis lymphocyte depleted: worse [radiopaedia.org]

The prognosis is very good for nodular lymphocyte-rich Hodgkin's lymphoma, even though there may be recurrence after time. Also with recurrence, the disease can be cured. [oncolex.org]

Named for the dense fibrous bands that subdivide involved lymph nodes, it has a prognosis slightly better than mixed cellularity HL. In formalin-fixed tissue a morphologically variant Reed-Sternberg cell called the "lacunar cell" is found. [pleiad.umdnj.edu]

Etiology

More than 100 recognized authorities from all parts of the world provide comprehensive, current information on every aspect of Hodgkin lymphoma, including etiology, epidemiology, biology, pathology, evaluation, staging, treatment, and follow-up. [books.google.com]

Despite recent advances and although there is good evidence that most if not all Hodgkin lymphomas are B-cell in origin, the etiology and pathogenesis of Hodgkin lymphoma remains largely unknown. [med-ed.virginia.edu]

Definitions LRCHL is type of classic Hodgkin lymphoma (CHL) in which small reactive lymphocytes associated with Hodgkin and Reed-Sternberg (HRS) cells predominate Neutrophils and eosinophils are rare or absent in background 2 variants: Nodular and diffuse ETIOLOGY [basicmedicalkey.com]

Etiology of Hodgkin’s Disease Causes of Hodgkin’s disease To date, the etiology of Hodgkin’s disease is not fully understood. [lecturio.com]

(Etiology) The exact cause of Lymphocyte-Rich Classical Hodgkin Lymphoma is not known. [dovemed.com]

Epidemiology

More than 100 recognized authorities from all parts of the world provide comprehensive, current information on every aspect of Hodgkin lymphoma, including etiology, epidemiology, biology, pathology, evaluation, staging, treatment, and follow-up. [books.google.com]

[…] absence of neutrophils and eosinophils (WHO 2008) Terminology ~30% of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) cases diagnosed in the past were found to be LRCHL Also known as follicular Hodgkin lymphoma ( Am J Clin Pathol 2002;117:29 ) Epidemiology [pathologyoutlines.com]

Fatigue Fever (for no known reason) Pain in the chest, abdomen, or bone s (for no known reason) Skin rash or itchy skin Weight loss (for no known reason) Diagnostic Exams Erythrocyte sedimentation rate Immunophenotyping Progression and Transformation None Epidemiology [seer.cancer.gov]

Comparing adult and pediatric Hodgkin lymphoma in the Surveillance, Epidemiology and End Results Program, 1988–2005: an analysis of 21 734 cases. Leuk Lymphoma. 2010;51:2198–207. [link.springer.com]

Pathophysiology

Thus, no indication was found that the tumor cells of the three types of lymphomas show a disease-specific gene expression pattern, which would have supported a distinct pathogenesis and pathophysiology of the tumor cells. [journals.plos.org]

Prevention

The exact cause of Lymphocyte-Rich Classical Hodgkin Lymphoma is unknown, and hence, no guidelines exist for the prevention of this type of cancer. [dovemed.com]

Patient care: major problems presented by the patient with non-Hodgkin's lymphoma include the management of side effects associated with treatment and the prevention of infection. small lymphocytic lymphoma a diffuse form of non-Hodgkin's lymphoma with [medical-dictionary.thefreedictionary.com]

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