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EBV may be expressed in the LP cells of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in both children and adults.
[hodgkin lymphoma, classical]
Nodular
lymphocyte-predominant
Hodgkin
lymphoma
(
NLPHL
)
and
classical
Hodgkin
lymphoma
(
CHL
)
are
classified
separately
because
of
their
distinct
clinical
and
pathologic
features
.
Whereas
Epstein-
Barr
virus
(
EBV
)
is
detected
in
the
neoplastic
cells
of
25
%
to
70
%
of
CHL
,
NLPHL
is
generally
considered
to
be
EBV
(
-
)
.
We
assessed
EBV
status
in
302
pediatric
and
adult
cases
of
NLPHL
.
A
total
of
145
pediatric
(
age
18
y
or
younger
)
and
157
adult
cases
of
NLPHL
were
retrieved
from
3
North
American
centers
and
tested
for
EBV
by
in
situ
hybridization
(
EBV-encoded
small
RNA
)
.
Clinical
and
pathologic
features
were
analyzed
.
Five
(
3
.
4
%
)
pediatric
and
7
(
4
.
5
%
)
adult
NLPHL
cases
contained
EBV
(
+
)
lymphocyte-predominant
(
LP
)
cells
.
Although
all
12
cases
met
the
criteria
for
diagnosis
of
NLPHL
,
atypical
features
were
present
,
including
capsular
fibrosis
,
atrophic
germinal
centers
,
and
pleomorphic
or
atypical
LP
cells
.
CD
2
0
and
OCT
-
2
were
strongly
and
diffusely
positive
in
all
except
1
case
.
However
,
PAX
5
and
CD
7
9
a
were
weak
and
/
or
variable
in
7
/
8
and
6
/
6
cases
tested
,
respectively
.
EBV
(
+
)
cases
were
more
likely
to
be
CD
30
(
+
)
(
75
%
)
compared
with
EBV
(
-
)
cases
(
25
%
)
(
P
=
0
.
0007
)
;
CD
15
was
negative
in
all
cases
.
Our
results
show
that
EBV
(
+
)
LP
cells
may
occur
in
NLPHL
.
Distinguishing
EBV
(
+
)
NLPHL
from
CHL
can
be
challenging
,
as
EBV
(
+
)
NLPHL
can
have
partial
expression
of
CD
30
and
weak
PAX
5
staining
as
well
as
pleomorphic-appearing
LP
cells
.
However
,
the
overall
appearance
and
maintenance
of
B-
cell
phenotype
,
with
strong
and
diffuse
CD
2
0
and
OCT
-
2
expression
,
support
the
diagnosis
of
NLPHL
in
these
cases
.
Diseases
Validation
Diseases presenting
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated