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The histology, cytology, and enzyme cytochemistry of a nodular variant of Hodgkin's disease with lymphocytic predominance, called 'nodular paragranuloma', are presented. The histological features of nodular paragranuloma are compared with those of progressively transformed germinal centres, which are enlarged follicles showing a predominance of small lymphocytes and some residual germinal centre cells. Progressively transformed germinal centres are sometimes found in nonspecific lymphadenitis (reactive hyperplasia). The histological similarity and the association between lymph nodes with nodular paragranuloma and lymph nodes with progressively transformed germinal centres in the same patient at different moments or at the same time, suggest that progressively transformed germinal centres are the origin of nodular paragranuloma. Hence, it must be concluded that nodular paragranuloma takes place in B-cell areas of the lymph node, unlike the other, or at least most of the other, types of Hodgkin's disease.
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