Tumour cell characteristics and microenvironment composition correspond to clinical presentation in newly diagnosed nodular lymphocyte‐predominant Hodgkin lymphoma

Different studies have characterized the microenvironment and its prognostic impact in classic Hodgkin lymphoma whereas such analyses are pending for nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL). We thus investigated characteristics of tumour cells and microenvironment in NLPHL and evaluated possible correlations with the clinical presentation. Lymph node samples from 152 NLPHL patients who had first‐line treatment within the randomized German Hodgkin Study Group HD16–HD18 trials were available and analysed with regard to IgD status and nuclear size of the tumour cells as well as presence of PD1‐positive follicular T helper cells and CD163‐positive macrophages in the microenvironment. While large tumour cell nuclei and high numbers of PD1‐positive follicular T helper cells in the microenvironment were more common in patients presenting with early/intermediate stages than in patients with advanced‐stage disease (p < 0.0001, unpaired t‐test; p = 0.0022, Mann–Whitney test), no differences between risk groups were observed in terms of the IgD status of the tumour cells and the content of CD163‐positive macrophages in the microenvironment. PD1‐positive follicular T helper cells were present in both cases with typical and variant growth patterns and rosetting around the tumour cells was observed in 96% of patients, indicating an important role of PD1‐positive follicular T helper cells in NLPHL.