Hodgkin’s lymphoma within the Rye classification

on 7.2.09 with 0 comments

  • Reed-Sternberg cells

    • “Classic” RS cells are large cells with abundant amphophilic cytoplasm and a mirror image binucleate or bilobed nucleus

    • Nucleus has large eosinophilic to amphophilic inclusion-like nucleoli surrounded by a clear halo (“Owl’s eyes”)

    • RS cells are admixed with a non-specific background of inflammatory cells (lymphocytes, plasma cells, eosinophils, macrophages)

    • Considered to be the neoplastic element in HD

    • RS cell variants

      • Lacunar: associated with nodular sclerosing Hodgkin’s

      • Popcorn (lymphohistiocytic, L + H): associated with lymphocyte predominant Hodgkin’s

      • Multinucleate

      • Mononuclear

  • Rye classification

    • Lymphocytic predominant

      • Mature lymphocytes and a variable number of benign histiocytes

      • Few eosinophils, neutrophils, or plasma cells

      • Usually no fibrosis or necrosis

      • Few “classic” RS cells, many more L + H variant

      • Easily mistaken for NH lymphocytic lymphoma

      • Males <>

    • Mixed cellularity

      • Diffuse heterogeneous infiltrate of mature lymphocytes, eosinophils, plasma cells, and benign histiocytes

      • May see small areas of necrosis and fibrosis

      • Many more classical RS cells

      • Males <>

      • More often disseminated with systemic symptoms and worse prognosis than lymphocyte predominant subtype

    • Lymphocyte depletion

      • Lack of histiocytes and lymphocytes, few classical RS cells

      • Necrosis and fibrosis may be prominent

      • Occurs more in older patients with disseminated disease and systemic symptoms

      • Worst prognosis

    • Nodular sclerosis

      • Varying proportions of lymphocytes, plasma cells, and eosinophils

      • Lacunar variant of RS cells more common than classic RS cells

      • Variable degree of fibrosis with birefringent bands of collagen dividing the nodes into circumscribed nodules

      • Most common form of HD and only form more common in women

      • Tends to be in lower cervical, supraclavicular, and mediastinal nodes in young patients

      • Excellent prognosis

Category: Medical Subject Notes , Pathology Notes



Post a Comment