Shet et al developed a histologic score for evaluating lymph node biopsies from patients with nodular lymphocyte predominant Hodgkin Disease. The authors are from Tata Memorial Hospital and St. John Medical College in India.
Patient selection: nodular lymphocyte predominant Hodgkin's disease
Parameters:
(1) percentage of nodularity in H&E sections
(2) extranodular LP (lymphocyte predominant) tumor cells on CD20 stain, as percent of extranodular area
(3) ratio of T cells (CD3 positive) to B cells (CD20 positive)
(4) type of nodules seen on H&E and CD20 stain
(5) loss of dendritic network on CD23 stain
|
Parameter |
Finding |
Points |
|
percent nodularity |
100% |
0 |
|
|
75 to less than 100% |
1 |
|
|
< 75% |
2 |
|
extranodalular LP cells |
0 to 14% |
0 |
|
|
15 to 50% |
1 |
|
|
> 50% |
2 |
|
T to B cell ratio |
T cells < 20% (predominantly B cell) |
0 |
|
|
T cells 20-50% |
1 |
|
|
T cells > 50% |
2 |
|
type of nodules |
well-defined |
0 |
|
|
irregular |
1 |
|
|
multinodular and interconnected |
2 |
|
loss of dendritic network |
focally or completely preserved |
1 |
|
|
lost in most areas |
2 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 1
• maximum score: 10
• A score > 6 was associated with a worse outcome.
|
Total Score |
5-Year DFS |
Median DFS |
|
1 to 6 |
90% |
133.6 months |
|
7 to 10 |
20% |
35 months |
Specialty: Hematology Oncology
