Nodular Lymphocyte Predominant Hodgkin Lymphoma With Sarcoid-Like Granulomas: A Rare Association

Özet

Granulomatous inflammation is commonly seen in Hodgkin lymphoma. However; the recent literature fails to correlate the subtypes of HL with granuloma. An occasional report describes association of mixed cellularity classical Hodgkin lymphoma with granulomatous reaction. None of other variants of HL are known to manifest with granulomatous reaction. We report a 34-year-old female patient who presented with swelling in right under arm for four months with no history of fever or weight loss. Fine needle aspiration cytology of axillary swelling revealed reactive lymphadenitis. To confirm the diagnosis lymph nodes excision was performed. Histomorphological examination revealed effacement of lymph node architecture by small to intermediate sized lymphoid cells with interspersed mononuclear Reed Sternberg cells like cells along with confluent and discrete non caseating granulomas. Additionally, immunohistochemical staining was performed, which rendered a diagnosis of nodular lymphocyte predominant Hodgkin lymphoma with granulomatous inflammation. This association is uncommon thereby making it pertinent for us to report this rare pathological entity also emphasis on careful microscopic evaluation of lymph node particularly with granulomatous reaction.