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Diffuse large B cell lymphoma derived from nodular lymphocyte predominant Hodgkin lymphoma presents with variable histopathology

Sylvia Hartmann1*, Mine Eray2, Claudia Döring1, Tuula Lehtinen3, Uta Brunnberg4, Paula Kujala2, Martine Vornanen2 and Martin-Leo Hansmann1

Author Affiliations

1 Dr. Senckenberg Institute of Pathology, Hospital of the Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main D- 60590, Germany

2 Department of Pathology, Tampere University Hospital and University of Tampere, Tampere 33520, Finland

3 Department of Oncology, Tampere University Hospital, Tampere 33520, Finland

4 Department of Internal Medicine 2, Hospital of the J. W. Goethe University, Frankfurt am Main, Germany

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BMC Cancer 2014, 14:332  doi:10.1186/1471-2407-14-332

Published: 13 May 2014



Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) usually presents in middle aged men and shows an indolent clinical behavior. However, up to 30% of the patients present a secondary transformation into aggressive diffuse large B cell lymphoma (DLBCL). The aim of the present study was to characterize morphology and immunophenotype of this kind of DLBCL in detail and compare it with conventional DLBCL.


Morphology and immunophenotype of 33 cases of NLPHL with simultaneous or sequential transformation into DLBCL were investigated. These cases were compared with 41 de novo DLBCL in Finnish men.


The majority of cases exhibited different immunophenotypes in the NLPHL and the DLBCL components. The immunophenotype of the DLBCL secondary to NLPHL was heterogeneous. However, BCL6, EMA, CD75 and J-chain were usually expressed in both components (≥73% positive). Overall, the NLPHL component was more frequently positive for EMA, CD75 and J-chain than the DLBCL component. In contrast, B cell markers, CD10 and BCL2, were more frequently expressed and were expressed at higher levels in the DLBCL component than in the NLPHL component. In the independent series of de novo DLBCL 4 cases could be identified with a growth pattern and immunophenotype that suggested that they had arisen secondarily from NLPHL.


The morphology and immunophenotype of DLBCL arisen from NLPHL is heterogeneous. Further characterization of the particular molecular features of this subgroup is warranted to be able to better identify these cases among conventional DLBCL.

Nodular lymphocyte predominant Hodgkin lymphoma; Diffuse large B cell lymphoma; Transformation