6.7 Hodgkin Lymphoma

Question 1

What is a Reed Sternberg cell?

Answer 1

Large B cell with multilobed nuclei and prominent nucleoli (owl-eyed nuclei) classically positive for CD15, 30
Cell found in Hodgkin Lymphoma

Question 2

Basics of Hodgkin Lymphoma

Answer 2

Not so much a continuous mass of neoplastic lymph cells like in NHL.
Reed-Sternberg cells secrete cytokines that attract inflammatory cells which make up the bulk of the tumor

Question 3

Effect of cytokines from Reed-Sternberg cells

Answer 3

B Sx: fever, chills, weight loss, night sweats
Attract other cells to form the tumor
Fibrosis

Question 4

What are the subtypes of Hodgkin Lymphoma?

Answer 4

Based on predominant cell type present in the tumor

1) Nodular sclerosis: most common, enlarging cervical node or mediastinal node in young adult, generally female; node divided by bands of sclerosis and RS cells in lake-like spaces (lacunar cells)
2) Lymphocyte-rich: best Px
3) Mixed cellularity: eosinophilia driven by IL-5
4) Lymphocyte-poor: most aggressive, elderly and HIV patients

Question 5

Young female patient presents with an enlarging lymph node in the neck. Histo shows owl-eyed cells that are CD15,30 positive. What else would be seen on histo? What other nodes are classically involved?

Answer 5

Nodular sclerosis type of HL
Histo would also show dividing bands of sclerosis in the nodes and Reed-Sternberg cells in lake-like spaces
Also classically involves mediastinal nodes