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Variant histology in nodular lymphocyte predominant Hodgkin lymphoma in an adult population: disease investigations and characteristics from a retrospective cohort
  1. Arthur Stacey1,
  2. Alexandra Jane Marks2,
  3. Kikkeri N Naresh3,4
  1. 1 Faculty of Medicine, Imperial College London, London, UK
  2. 2 Haematology, Imperial College Healthcare NHS Trust, London, UK
  3. 3 Histopathology, Imperial College London Centre for Haematology, London, UK
  4. 4 Section of Pathology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  1. Correspondence to Mr Arthur Stacey, Imperial College London Faculty of Medicine, London, London, UK; arthur.stacey1{at}


A subset of variant histological patterns of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) has been associated with advanced disease stage and increased recurrence risk. Histopathology reports on core needle (CNB) and/or surgical excision biopsies (SEB) for 33 adult patients with NLPHL were examined for variant histology prevalence and association with disease stage and clinical outcome. Variant histological pattern was present in 13/33 patients (39%). Obtained tissue was inadequate for diagnosis in 1/23 (4.3%) cases of CNB. Variant histology was associated with stage IV disease at presentation (p<0.001). While SEB should be the procedure of choice in workup of patients for a diagnosis of NLPHL, CNB is an alternate option when SEB is contraindicated or difficult to undertake. Diagnostic reports should specifically note presence of variant histological patterns. Although late-stage disease was associated with progression or recurrence, overall prognosis is excellent for patients with NLPHL.

  • Hodgkin Disease
  • Image-Guided Biopsy
  • Hematologic Diseases

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  • Handling editor Runjan Chetty.

  • Contributors AS: extracted the data, participated in statistical analysis and wrote the manuscript. AJM: study design, oversaw study execution, edited and revised the manuscript. KNN: study design and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.