Hodgkin Lymphoma

Question 1

Reed-Sternburg Cells

Answer 1

Large B-cell w/ multilobed nuclei and prominent nucleoli
Secrete cytokines that draw in inflammatory cells –> create a mass
2 nuclear lobes, large inclusion-like nucleoli, abundant cytoplasm, red eosinophilic nucleoli
Surrounded by lymphocytes, macrophages, eosinophils

Question 2

Hodgkin Lymphoma

Answer 2

Neoplastic prolif of Reed-Sternburg cells
CD15+, CD30+, CD20-
Owl-eyed cells
Subtypes: nodular sclerosis, lymphocyte-rich, mixed cellularity, lymphocyte-depleted, lymphocyte predominence

Question 3

Nodular sclerosis HL

Answer 3

Most common HL - w/ enlarging cervical neck or mediastinal LN
Dense fibrosis
Background: T lymph, Eos, macrophages, plasma cells, fibrous bands
RS cells (present in lacunar cells): PAX5, CD15+, CD30+, EBV+

Question 4

Lymphocytic-rich HL

Answer 4

Best PX
Background: T lymph
RS cells: PAX5, CD15+, CD30+, EBV-

Question 5

Mixed Cellularity HL

Answer 5

Most common HL in >50yo
Ax w/ abundant eosinophils, IL-5
Background: T lymph, Eos, Macrophages, Plasma cells
RS cells: PAX5, CD15+, CD30+, EBV+

Question 6

Lymphocyte-depleted HL

Answer 6

Worst PX
Elderly w/ HIV+
Background: reactive cells
RS cells: PAX5, CD15+, CD30+, EBV+

Question 7

Lymphocyte Predominence

Answer 7

Non-RS cell L+H (popcorn cell) = pale staining Lymphohistiocytic variants surrounded by mature-looking lymphocytes
Background: Follicular DCs, Reactive B-cells
RS cells: CD20+, CD15-, CD30-, EBV-, BCL6+

Question 8

HL

Answer 8

Bimodal age distribution: 20-29; >70yo
Localized to a singal axial group of nodes
Contiguous spread
Rarely involve pharyngeal/mesenteric nodes or extranodal
Excellent rspn to CTX

Question 9

NHL

Answer 9

Elderly >50yo
Involved multiple peripheral nodes
Noncontiguous spread
Waldeyer ring and Mesenteric nodes involved
Extranodal presentation
Poor rspn to CTX

Question 10

Stage I of HL and NHL

Answer 10

involvement of a single LN region, or a single extra-lymphatic organ or site

Question 11

Stage II of HL and NHL

Answer 11

involvement of +2 LN regions on same side of diaphragm or localized involvement of an extra-lymphatic organ/site

Question 12

Stage III of HL and NHL

Answer 12

involvement of LN regions on both sides of diaphragm w/out or w/localized involvement of an extra-lymphatic organ/site

Question 13

Stage IV of HL and NHL

Answer 13

diffuse involvement of +1 extra-lymphatic organs/sites w/ or w/out lymphatic involvement