Schematic diagram of histopathologic patterns in NLP and relevant ICC grades (IMAGE)
Caption
Fan pattern A, so-called classical B-cell-rich nodular pattern: Clusters of single LP cells are embedded within enlarged follicles/nodules predominantly composed of small B-cells. Reactive T-cells are mainly in the interfollicular areas. The FDC meshworks are expanded and associated with the atypical follicles/nodules. Fan pattern B, so-called serpiginous/interconnected pattern: Similar to Fan pattern A, LP cells are mainly within B-cells rich atypical follicles/nodules, which interconnect with each other. Fan pattern C, so-called prominent extra-nodular LP cells pattern: LP cells extend beyond the follicular compartment with an internodular distribution. Fan pattern D, so-called T-cell-rich nodular pattern: LP cells distribute in a vaguely nodular pattern, but normal follicular B-cells are lost, and the atypical nodules are rich in T-cells. FDC meshworks are usually still present. Fan pattern E, so-called diffuse pattern (THRLBL or DLBCL-like): The growth pattern is diffuse. LP cells are widely scattered in a background rich in T-cells and histiocytes. FDC meshworks are lost and normal admixed B-cells are largely absent. Fan Pattern F, the so-called diffuse moth-eaten, B-cell-rich pattern: The LP cells are scattered in a background that is rich in both small B-cells and T-cells. The FDC meshworks are absent. Per ICC classification, Fan Patterns A, B, and C are categorized as grade 1, and Fan patterns D, E, and F are categorized as grade 2. DLBCL, diffuse large B-cell lymphoma; FDC, follicular dendritic cells; NLP, nodular lymphocyte predominant Hodgkin lymphoma/nodular lymphocyte predominant B-cell lymphoma; ICC, International Consensus Classification; LP, lymphocyte-predominant; THRLBL, T-cell/histiocytes-rich large B-cell lymphoma.
Credit
Elaine S. Jaffe, Yanna Ding
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