Hodgkin Lymphoma and Pathology of WBCs

Question 1

How does HL differ from NHL?

Answer 1

1. Arises from single node
2. Spreads in contiguous fashion
3. Neoplastic cell is the Reed-Sternberg Cell
4. Occurs in young adults and adults age 45
5. Curable

Question 2

Describe the morphology of the Reed- Sternberg Cell

Answer 2

Huge, 15-45um, large inclusion-like nucleolus. Different variants include- classic (bi or multi lobed), mononuclear (1 lobe), lacunar (appears sitting in hole) and L&H (inconspicuous nucleoli that look like popcorn- specific to NLPHL)

Question 3

Immunophenotype of Reed Sternberg Cells

Answer 3

1. Classic: CD15/CD30+, negative for CD45, B and T antigens

2. NLPHL: B Cell antigen +, CD45 +, BCL6 +, negative for CD15/CD30

Question 4

What are the features of Nodular Sclerosing Hodgkin Lymphoma? (4)

Answer 4

1. 70% cases
2. Cervical, supraclavicular and mediastinal lymph nodes
3. Lacunar cells and bands of polarizing fibrosis
4. Polymorphous background

Question 5

What are the features of Hodgkin Lymphoma (Classic)?

Answer 5

1. 25% of cases
2. EBV associated
3. Typically older ages, B symptoms and presents at advanced stage
4. Diffuse effacemen by heterogeneous infiltrate
5. A lot of RS cells

Question 6

What is Leukopenia?

Answer 6

A decrease in White Blood Cells- the main decrease is in T Cells (mainly CD4+)

Question 7

What are some causes of Leukopenia?

Answer 7

1. Congenital Immunodeficiency Disease
2. Autoimmune Disease (SLE)
3. Advanced HIV
4. Glucocorticoids or Cytotoxic Drugs
5. Systemic Illness
6. Malnutrition

Question 8

What are 2 possible causes of Neutropenia?

Answer 8

Vitamin B12 and Folate Deficiencies

Myelodysplastic Syndromes

Question 9

What is Leukocytosis?

Answer 9

An increase in WBCs

Question 10

What are some possible causes of Leukocytosis?

Answer 10

1. Drugs

2, Acute viral illness (EBV, CMV)