Pathology

The neoplastic cells of nLPHL are large cells with vesicular chromatin, scant cytoplasm, and folded nuclear contours. Due to the characteristically extreme nuclear lobation, these cells are frequently described as "popcorn cells." These cells are also known as "L&H cells," a holdover of terminology from the Lukes and Butler classification that defined such cases as "lymphocytic and histiocytic Hodgkin disease."16 Prototypical cases of nLPHL show effacement of the lymph node architecture by a nodular lymphoid proliferation. The nod

Figure 71.6 Nodular lymphocyte predominant Hodgkin's lymphoma. The neoplastic cells in nLPHL show multiple nuclear lobes with vesicular chromatin and prominent nucleoli (left). There is strong expression of CD20 (right)

ules consist of many small B-cells, with scattered L&H cells (Figures 71.5 and 71.6).17<40<41 Similar appearing diffuse areas may also be present. When diffuse areas are extensive, distinguishing nLPHL from TCRLBL may be quite difficult, especially in small biopsy specimens.

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