Hodgkin's lymphoma pathophysiology: Difference between revisions

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Revision as of 19:16, 4 September 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Pathophysiology

Gross Pathology

Affected lymph nodes (most often, laterocervical lymph nodes) are enlarged, but their shape is preserved because the capsule is not invaded. Usually, the cut surface is white-grey and uniform; in some histological subtypes (e.g. nodular sclerosis) may appear a nodular aspect

Microscopic Pathology

Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual CD45-, CD30+, CD15+/- immunophenotype. In approximately 50% of cases, the Reed-Sternberg cells are infected by the Epstein-Barr virus.

**Reed-Sternberg cells (RSC) (Classical and variants)**
Type of cell	Characteristics
Classic
Reed-Sternberg cells (RSC)	Include large size (20–50 micrometres), abundant, amphophilic, finely granular/homogeneous cytoplasm; two mirror-image nuclei (owl eyes) each with an eosinophilic nucleolus and a thick nuclear membrane (chromatin is distributed close to the nuclear membrane).
Variants
Hodgkin cell	(Atypical mononuclear Reed-Sternberg cell) has the same characteristics as Reed-Sternberg cells (RSC), but is mononucleated.
Lacunar Reed-Sternberg cells	Are large, with a single hyperlobulated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space ("lacunae").
Pleomorphic Reed-Sternberg cells	Has multiple irregular nuclei.
"Popcorn" Reed-Sternberg cells	(Lympho-histiocytic variant) is a small cell, with a very lobulated nucleus, small nucleoli.
"Mummy" Reed-Sternberg cells	has a compact nucleus with no nucleolus and basophilic cytoplasm.

References

↑ http://picasaweb.google.com/mcmumbi/USMLEIIImages

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[1] ttp://picasaweb.google.com/mcmumbi/USMLEIIImages

[1]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Hodgkin's lymphoma}}
-{{CMG}}
+{{CMG}}; {{AE}} {{AS}}
 ==Pathophysiology==
@@ Line 12: / Line 13: @@
 Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual [[CD45]]-, [[CD30]]+, [[CD15]]+/- immunophenotype.  In approximately 50% of cases, the Reed-Sternberg cells are infected by the [[Epstein-Barr]] [[virus]].
-Characteristics of classic Reed-Sternberg cells include large size (20&ndash;50 micrometres), abundant, amphophilic, finely granular/homogeneous cytoplasm; two mirror-image nuclei (owl eyes) each with an eosinophilic nucleolus and a thick nuclear membrane ([[chromatin]] is distributed at the cell periphery).
+{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
+|+ ''' Reed-Sternberg cells (RSC) (Classical and variants) '''
+! style="background: #4479BA; color:#FFF;" | Type of cell
+! style="background: #4479BA; color:#FFF;" | Characteristics
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''Classic'''
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" | Reed-Sternberg cells (RSC)
+| style="padding: 5px 5px; background: #F5F5F5;" | Include large size (20–50 micrometres), abundant, amphophilic, finely granular/homogeneous [[cytoplasm]]; two mirror-image [[nuclei]] (owl eyes) each with an eosinophilic [[nucleolus]] and a thick [[nuclear membrane]] ([[chromatin]] is distributed close to the nuclear membrane).
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''Variants'''
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" | Hodgkin cell
+| style="padding: 5px 5px; background: #F5F5F5;" | (Atypical mononuclear Reed-Sternberg cell)  has the same characteristics as Reed-Sternberg cells (RSC), but is mononucleated.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" | Lacunar Reed-Sternberg cells
+| style="padding: 5px 5px; background: #F5F5F5;" | Are large, with a single hyperlobulated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space ("lacunae").
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" | Pleomorphic Reed-Sternberg cells
+| style="padding: 5px 5px; background: #F5F5F5;" | Has multiple irregular nuclei.
-Variants:
+|-
-* Hodgkin's cell (atypical mononuclear RSC) is a variant of RS cell, which has the same characteristics, but is mononucleated.
+| style="padding: 5px 5px; background: #F5F5F5;" | "Popcorn" Reed-Sternberg cells
-* Lacunar RSC is large, with a single hyperlobated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space ("lacunae").
+| style="padding: 5px 5px; background: #F5F5F5;" | (Lympho-histiocytic variant) is a small cell, with a very lobulated nucleus, small nucleoli.
-* Pleomorphic RSC has multiple irregular nuclei.
-* "Popcorn" RSC (lympho-histiocytic variant) is a small cell, with a very lobulated nucleus, small nucleoli.
-* "Mummy" RSC has a compact nucleus, no nucleolus and basophilic cytoplasm. <ref>[http://www.pathologyatlas.ro/Reed%20Sternberg%20Cell%20Hodgkin%20Lymphoma.html]</ref>
-Hodgkin's lymphoma can be sub-classified by histological type.  The cell histology in Hodgkin's lymphoma is not as important as it is in [[non-Hodgkin's lymphoma]]: the treatment and prognosis in Hodgkin's lymphoma depend on the stage of disease rather than the histotype.
+|-
+| style="padding: 5px 5px; background: #F5F5F5;" | "Mummy" Reed-Sternberg cells
+| style="padding: 5px 5px; background: #F5F5F5;" | has a compact nucleus with no nucleolus and basophilic cytoplasm.
+|}
 ==References==
@@ Line 35: / Line 55: @@
 [[Category:Mature chapter]]
 [[Category:primary care]]
-[[Category:Needs overview]]