Histopathological and clinical features of nodular lymphocyte-predominant Hodgkin lymphoma and their impact on prognosis: first report from Iran

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma (HL). It shows different histoarchitectural patterns which are reported to be of prognostic significance. This study aimed to investigate the clinicopathological features of NLPHL cases in Shiraz, Iran, and their possible impact on prognosis. Between March 2014 and November 2019, all records for lymphoma were extracted from the electronic files of hospitals affiliated with Shiraz University of Medical Sciences. The slides of all NLPHL cases were extracted and reviewed. Other necessary data was retrieved from hospital records and through direct contact with patients. Among1168 lymphoma cases, 382 were HLs and 19.1% (73) of them were of the NLPHL type. The median age of NLPHL patients was 34 years. Of the patients, 51.5% showed variant patterns, and 11% of them had BM involvement. The variant morphology was significantly associated with BM involvement (p = 0.02). Patients with higher stage tumors had lower OS and PFS rates. Stage, BM involvement, and infra-diaphragmatic involvement were significantly associated with outcomes. The rate of NLPHL and variant morphology seems to be high in our center in Iran. The variant morphology was associated with a higher BM involvement rate but not with OS or PFS. Higher stage, BM, and subdiaphragmatic disease involvement were associated with worse outcomes.