I. Shupletsova, A. Kovrigina, T. Moiseeva, E. Dorokhina
National Research Center for Hematology, Ministry of Healthcare of Russian Federation, Moscow
Introduction: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is characterized by predominantly nodal involvement, indolent course of disease, but it can affect extranodal localization, including bone marrow (BM).
Objective: To characterize the extranodal lesions in patients with NLPHL in the debut of the disease and to compare the immunoarchitectonics of the tumor substrate in the lymph node (LN)/other lymphoid tissue of the primary biopsy and bone marrow biopsy (BMB).
Materials and methods: The study group included 37 pts with verified diagnosis (morphology, IHC) of NLPHL (2010–2017, NRCH for hematology): m/f ratio 2.7: 1, median age - 37 (range 17–62), with biopsy material of LN/other localization of the primary biopsy and BMB in the debut of the disease. All cases were characterized by immunoarchitectural patterns (WHO 2017) in primary biopsy and BMB (iliac bone). Clinical stages were established according to Ann Arbor.
Results: Patients of the study group were divided into two subgroups, depending on the of bone marrow lesion in the debut of the disease: 1st subgroup - 9 pts with BM involvement (24%), 2nd subgroup - 28 pts without BM involvement. Clinical and laboratory data are summarized in the Table 1. 9 pts of 1st subgroup had identical immunoarhitectural patterns in primary biopsy and BMB: 1 pt- pattern C; 4 pts- pattern D; 4 pts – pattern E.
Conclusions: Ist group of pts with BM involvement in debut of disease have characterized by more often extranodal lesion. The BM involvement is a manifestation of the hematogenous spread of the disease with a complex of extranodal lesions. Our study revealed the identical immunoarchitectural patterns (C-E) in primary biopsy and BM lesion in all cases.