Nodular Lymphocyte-Predominant Hodgkin Lymphoma with Splenic and Multiple Bone Involvement: Case Report

Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL), accounting only for 5% of all HL cases, presents as a diagnostic challenge due to its rare occurrence and diverse morphological features. The malignant lymphocyte predominant (LP) cells in NLPHL are positive for CD20 but lack CD30 and CD15, in contrast to the disease-defining Hodgkin and Reed-Sternberg (H-RS) cells in classical Hodgkin lymphoma (cHL). We report a rare instance of NLPHL stage IV B with spleen and multiple bone involvement in a young patient, diagnosed based on lymph node biopsy and PET/CECT. Furthermore, this case emphasizes the successful application of the R-CHOP regimen in the management of advanced NLPHL, highlighting its potential as a viable therapeutic strategy.