Hodgkin's disease of the tonsil: clinical, histological, immunophenotypical features and association with Epstein-Barr virus

OBJECTIVE: To characterize clinical, histological and immunophenotypical fe atures of a rare Hodgkin's disease presentation. METHODS: Retrospective analysis of three personal cases of Hodgkin's diseas e of the tonsil and a review of the literature. RESULTS: The clinical presentation was localized in the tonsil in all three cases. Age at onset was over 40 years in ail patients. Symptoms were typic al. A mixed cellularity histological type was found in ail 3 instances. Ree d-Sternberg cells stained positively with anti-CD30 and anti-CD15 monoclona l antibodies as well as with an anti-Epstein-Barr virus (EBV) specific mono clonal antibody. All 3 patients are currently in complete remission althoug h for a short period of time (35, 20 and 15 months). CONCLUSION: This small series illustrates the main characteristics of this rare Hodgkin's disease presentation. Age at onset was older than the averag e for this disease which might explain the predominance of the mixed cellul arity histologic subtype and the tigher linkage to EBV, although the rarity of such a presentation could raise some doubts about the EBV linkage. Prog nosis of this unusual presentation does not appear to be different from tha t for more common presentations.