Hodgkin's lymphoma pathophysiology

Hodgkin's lymphoma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Hodgkin's lymphoma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray Findings
CT
MRI
Ultrasound
Biopsy
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hodgkin's lymphoma pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Hodgkin's lymphoma pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hodgkin's lymphoma pathophysiology
CDC on Hodgkin's lymphoma pathophysiology
Hodgkin's lymphoma pathophysiology in the news
Blogs on Hodgkin's lymphoma pathophysiology
Directions to Hospitals Treating Hodgkin's lymphoma
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.

• 

  Reed-Sternberg Hodgkin's Lymphoma

• 

  Micrograph showing Hodgkin lymphoma (Field stain)

• 

  Micrograph showing a "popcorn cell", the Reed–Sternberg cell variant seen in nodular lymphocyte predominant Hodgkin lymphoma. H&E stain

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

Template:WikiDoc Sources