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Nodular Lymphocyte-Predominant Hodgkin Lymphoma

Nodular Lymphocyte Predominant Hodgkin Lymphoma


Presentation

  • The purpose of the present report is to define the biology of NLPHL, review its clinical presentation, and summarize the available clinical data regarding treatment. Copyright 2014 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
Fatigue
  • A 14-year-old male patient presented with a nonproductive cough, weight loss, fatigue, and malaise.[ncbi.nlm.nih.gov]
  • […] predominance Corresponding ICD-10 Codes C81.0 Hodgkin's disease, lymphocytic predominance Corresponding ICD-10-CM Codes (U.S. only) C81.0 Nodular lymphocyte predominant Hodgkin lymphoma (effective October 01, 2015) Signs and Symptoms Drenching night sweats Fatigue[seer.cancer.gov]
  • There may be non-specific symptoms such as fever, fatigue, swollen lymph nodes that are not painful, and unintended weight loss The diagnosis of Nodular Lymphocyte-Predominant Hodgkin Lymphoma may be established through a biopsy of the affected lymph[dovemed.com]
  • It is sometimes accompanied by symptoms such as fever, weight loss, fatigue, and night sweats. An obsolete term referring to hodgkin lymphoma.[icd9data.com]
  • If your child has Hodgkin lymphoma, the following symptoms may be present: Swollen (but not sore) lymph nodes in the neck, chest, armpit or groin Extreme fatigue Loss of appetite Weight loss Fever Night sweats Itchy skin How is Hodgkin lymphoma treated[stjude.org]
Aspiration
  • Two weeks into the chemotherapy, gastric aspirates grew Mycobacterium avium intracellulare. This is the first case of nodular lymphocyte predominant Hodgkin lymphoma involving the lung with coexistent Mycobacterium avium intracellulare.[ncbi.nlm.nih.gov]
  • Bone marrow examination often reveals characteristic hemophagocytes— histocytes with engulfed hematopoietic elements, including nucleated erythroid precursors, white blood cell precursors, and platelets—which are best depicted in marrow aspirate smears[gotoper.com]
  • Bone marrow aspiration and biopsy were normal. Plasma metanephrine, plasma renin activity, serum aldosterone, dehydroepiandrosterone and basic metabolic panel test results were all normal.[spandidos-publications.com]
Parotid Mass
  • The patient was found to have a parotid mass, which was diagnosed as NLPHL, and a thymic mass diagnosed as cHL, of nodular sclerosis subtype concurrently. The lesion in the parotid showed features typical of NLPHL by morphology and immunophenotype.[ncbi.nlm.nih.gov]
Lacrimation
  • CT scan of the orbits with and without contrast demonstrated homogenous enhancement of the left lacrimal gland. Examination was notable for left hypoglobus and proptosis.[ncbi.nlm.nih.gov]
Anger
  • Médicales, Gustave Roussy, Villejuif, France. 3 Hopital Saint-Louis APHP, Université Paris Diderot, France. 4 Department of Hematology, IUC Toulouse Oncopole, France. 5 Unité Hémopathies Lymphoïdes, AP-HP CHU Mondor, Créteil, France. 6 Maladies du Sang, CHU Angers[ncbi.nlm.nih.gov]
Tonic-Clonic Seizure
  • We report a case of Hodgkin lymphoma in a 25-year-old male patient who had been treated with diphenylhydantoin sodium for generalized tonic clonic seizures for 15 years.[ncbi.nlm.nih.gov]

Workup

  • Subsequent workup confirmed stage II A, nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) involving the neck. The large atypical cells were positive for CD20, CD45, and CD30.[hematologyandoncology.net]
  • Biopsy of the mass and a thorough staging workup revealed Stage IA NLPHL. The patient received external beam radiation therapy (EBRT) of 40 Gy in 20 fractions to the mantle field. He was followed annually for 13 years without evidence of disease.[omicsonline.org]
Anterior Mediastinal Mass
  • Case 2 was a 28-year-old woman who underwent surgical resection of an anterior mediastinal mass. The histology and microenvironment of both specimens resembled those of nodular lymphocyte predominant Hodgkin lymphoma.[ncbi.nlm.nih.gov]
Liver Biopsy
  • The liver biopsy of a 40-year-old man with febrile episodes and cholestatic laboratory pattern disclosed an uncommon subtype of HL, a nodular lymphocyte-predominant HL (NLPHL).[ncbi.nlm.nih.gov]

Treatment

  • Treatment at disease recurrence should be chosen on the basis of various factors, including histology at relapse, time to relapse, extent of disease at relapse, and prior treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Transformation from an NLPHL to a T/HRBCL can occur and is associated with a worsening of the prognosis. Here is described a case of a 16-year-old boy who presented with an NLPHL with features of T/HRBCL.[ncbi.nlm.nih.gov]

Etiology

  • An extensive diagnostic work up was performed to rule out infectious etiologies. Biopsies of the lymph node and lung tissue were diagnostic of nodular lymphocyte predominant Hodgkin lymphoma.[ncbi.nlm.nih.gov]
  • Although the association between diphenylhydantoin therapy and the development of immunosuppression and lymphoma is well-documented, the role of the drug in the etiology of these disorders is still controversial.[ijpmonline.org]
  • […] interleukins (IL) 4, 6, 8, 10, and 12; and soluble IL-2 receptor (sCD25) have been recorded in patients with HLH in combination with impaired/absent natural killer (NK) cell activity. 3 The aforementioned parameters can aid in distinguishing this syndrome from etiologies[gotoper.com]
  • (Etiology) The exact cause of Nodular Lymphocyte-Predominant Hodgkin Lymphoma is not known.[dovemed.com]

Epidemiology

  • KEYWORDS: Chemotherapy; Epidemiology; Nodular lymphocyte predominant Hodgkin lymphoma; Outcome; Radiotherapy[ncbi.nlm.nih.gov]
  • […] rash or itchy skin Splenomegaly Weight loss (for no known reason) Diagnostic Exams Erythrocyte sedimentation rate Immunophenotyping Progression and Transformation Advanced stages have unfavorable prognosis Disease develops slowly with frequent relapses Epidemiology[seer.cancer.gov]
  • : Hodgkin's paragranuloma Lukes and Butler: Lymphocytic and/or histiocytic (L&H) predominance Hodgkin's disease Kiel group: nodular paragranuloma Rye: Lymphocytic predominance Hodgkin's disease REAL: Nodular lymphocyte predominance Hodgkin's disease Epidemiology[e-immunohistochemistry.info]
  • "A 20-year population-based study on the epidemiology, clinical features, treatment, and outcome of nodular lymphocyte predominant Hodgkin lymphoma". Ann Hematol. 95 (3): 417–423. doi : 10.1007/s00277-015-2578-6. PMC 4742486.[en.wikipedia.org]
Sex distribution
Age distribution

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 Nodular Lymphocyte-Predominant Hodgkin Lymphoma is unknown, and hence, no guidelines exist for the prevention of this type of cancer.[dovemed.com]
  • However, rituximab alone is not sufficient to prevent relapses after first- or second-line treatment.[karger.com]
  • In order to prevent damage to the kideny from radiotherapy and to reduce treatment-related toxicity, the patient was treated only with ABVD adjuvant chemotherapy following a laparoscopic left adrenalectomy.[spandidos-publications.com]
  • Different MHC I molecules are up-regulated between two- and fivefold in L&H cells (unpublished data), which may prevent the elimination of these cells by NK cells. CD59 (3.6-fold up-regulated) inhibits the formation of the membrane attack complex.[jem.rupress.org]

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