<B>Hodgkin's Disease, Lymphocyte Predominant Type </B>

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Hodgkin's Disease, Lymphocyte Predominant Type

Etiology:

• Unknown

Pathogenesis:

• Very small population of neoplastic cells of L(ymphocyte) and H(istiocytic) subtype
• Marked inflammatory reaction driven by cytokines secreted by neoplastic cells including IL 5 (attracting eosinophils), IL4, tumor necrosis factor alpha, GM-CSF

Epidemiology:

• 0.7% of all new cancers in the U.S. overall for Hodgkin's Disease
• Predominantly male and under 35
• Usually cervical lymph nodes
• Relatively rare subtype

General Gross Description:

• Large fleshy tan node which may show ill defined nodularity

General Microscopic Description:

• Usually predominantly composed of small lymphoctyes, although histiocytes may be seen and may predominate (correct term is lymphocytic and/or histiocytic subtype
• Difficult to find diagnostic binucleate Reed-Sternberg cells with eosinophilic macronucleoli ("owl eye")
• Polypoid mononuclear variant with complex nuclear outline, chromatin clearing, inconspicous nucleoli
• Aberrant mitoses (ring shaped)
• Mummified cells
• Malignant cells demonstrate B cell markers including CD45+, CD30-, CD15-

Clinical Correlations:

• Tend to be confined to cervical lymph node(s) but may spread continguously
• Carries an excellent prognosis

References:
• Jaffe ES, Surgical Pathology of the Lymph Nodes and related organs, second edition, W.B. Saunders; Philadelphia, 1995, pp.141-151.