Recurrent Nodular Lymphocyte Predominant Hodgkin Lymphoma with Diagnostic Evolution Over Two Decades.
Swetha Atluri, Fred Schiffman
✦ AI-curated · Sources linked
Case in brief
A 51-year-old man had a nearly 20-year history of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), with multiple relapses and prolonged remissions. Over the course of his disease, the diagnosis was reclassified, reflecting the challenge of distinguishing NLPHL from lymphocyte-rich classical Hodgkin lymphoma. His management also involved treatment de-escalation, including active surveillance for asymptomatic relapsed disease.
What made this case unusual
The case brings together repeated relapses over nearly two decades, diagnostic reclassification between NLPHL and lymphocyte-rich classical Hodgkin lymphoma, and surveillance of asymptomatic relapse.
Diagnostic / clinical pearl
Distinguishing NLPHL from lymphocyte-rich classical Hodgkin lymphoma can be diagnostically challenging; reassessment of the diagnosis may be important when the clinical course evolves.
Why it matters
The case illustrates that prolonged remissions and asymptomatic relapse can inform management decisions, including active surveillance and treatment de-escalation.