36 year old, Jemima, is sent for mediastinoscopy with biopsy. During this procedure, a small incision is made immediately above the sternum and a rigid tube is inseed into the chest cavity for visualization of the mediastinum by video camera. Several biopsies of lymph nodes are taken and sent for pathologic examination. In these biopsies, the normal lymphoid tissue has been replaced by a mixed population of morphologically normal cells including histiocytes, lymphocytes, monocytes, plasma cells, and eosinophils. Admixed with these cells are infrequent numbers of large binucleate cells with large prominent eosinophilic nucleoli. Immunophenotyping demonstrates that these cells are positive for CD15 and CD30. The CD15 and CD30 positive cells are most likely which of the following?
Reed-Sternberg (RS) cells are typically binucleate (or contain bilobed nuclei) with prominent "owl's eyes" nucleoli. These cells must be identified before the diagnosis of Hodgkin disease can be made. The RS cell and RS variants express CD30, a lymphoid activation antigen. CD15, a granulocyte antigen, is also uniformly positive in RS cells. Aschoff cells are modified histiocytes with a ribbon-like pattern of chromatin dispersal, which are seen in rheumatic fever. Langhans giant cells are cells with large numbers of nuclei seen in granulomatous diseases such as tuberculosis. Megakaryocytes contain many nuclei and are usually found in bone marrow.
Aschoff cells
Langhans giant cells
Megakaryocytes
Reed-Sternberg cells