Hodgkin's lymphoma pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
====Gross Pathology==== | ====Gross Pathology==== | ||
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====Microscopic Pathology==== | ====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]]. | 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]]. | ||
<gallery widths=200px> | |||
Image:Reed-Sternberg (Hodgkin's Lymphoma).jpg|Reed-Sternberg Hodgkin's Lymphoma<ref>http://picasaweb.google.com/mcmumbi/USMLEIIImages</ref> | |||
Image:197px-Hodgkin lymphoma cytology large.jpg|Micrograph showing Hodgkin lymphoma (Field stain) | |||
Image:199px-Popcorn cell in nodular lymphocyte predominant Hodgkin lymphoma - very high mag cropped.jpg|Micrograph showing a "popcorn cell", the Reed–Sternberg cell variant seen in nodular lymphocyte predominant Hodgkin lymphoma. H&E stain | |||
</gallery> | |||
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Revision as of 19:36, 4 September 2015
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Hodgkin's lymphoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hodgkin's lymphoma pathophysiology On the Web |
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American Roentgen Ray Society Images of Hodgkin's lymphoma pathophysiology |
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Risk calculators and risk factors for Hodgkin's lymphoma pathophysiology |
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.
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![Reed-Sternberg Hodgkin's Lymphoma[1]](/images/a/a7/Reed-Sternberg_%28Hodgkin%27s_Lymphoma%29.jpg)
Reed-Sternberg Hodgkin's Lymphoma[1]
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Micrograph showing Hodgkin lymphoma (Field stain)
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Micrograph showing a "popcorn cell", the Reed–Sternberg cell variant seen in nodular lymphocyte predominant Hodgkin lymphoma. H&E stain
![Reed-Sternberg Hodgkin's Lymphoma[1]](/index.php/File:Reed-Sternberg_(Hodgkin%27s_Lymphoma).jpg)
| 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. | |