Nodular lymphocyte predominant Hodgkin lymphoma: case report and literature review

Written by Horváth Emőke, Turcu Mihai, Mezei Tibor, Kiss Éva, Baghiu Despina, Pávai Zoltán, Chira Liliana

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) accounts for 3-5% of NHML. It is characterized by slow progression and favourable prognosis. Its porphologic and immunophenotypic properties are different from these of classical Hodgkin lymphoma, therefore it is recognized as a different entity by WHO. Association of NLPHL with nephrotic syndrome has both therapeutic and prognostic implications. We present the case of a 5-year-old child with nephrosis syndrome with partial response to therapy. During treatment a laterocervical lymphadenopathy developed which, after histologic examination, proved to be a reactive lesion with progressively transformed germinal centers (PTGC). A second biopsy confirms the diagnosis of a malignant lymhoma. The morphology and immunophenotype is that of a NLPHL. Specific therapy leads to complete tumour remission and the disappearance of the nephrosis syndrome. Nephrosis syndrome with minimal glomerular change might represent a paraneoplastic syndrome in Hodgkin lymhoma. The particularity of our case is that the nephrotic syndrome preceeded the appearance of Hodgkin’s disease, a phenomenon rarely mentioned in the literature. Lymphadenopathy associated with nephrotic syndrome poses several diagnostic challenges. In solving these challenges immunohistochemistry has a major role.


Keyword: Hodgkin lymphoma, nephrotic syndrome

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