Hodgkin's lymphoma with lacunar cells is?
Ans. is 'b' i.e., Nodular sclerotic type Distinctive features of different types of HD1) Nodular sclerosis* It is the most common variant of HD. It is the only variant which is equally common in females and males (all other variants are more common in males). It occurs in adolescent and young adults. It frequently involves mediastinum.* Lacunar cells are seen on histology. It has excellent prognosis (2nd best after lymphyocytic predominance type). Reed-Sternberg cells are positive for CD 15 and CD 30. Fibrous bands are present which divide cellular areas into nodules : nodular sclerosis. Cellular components are lacunar cells, occasional RS cells, T-cells, eosinophils, plasma cells and macrophages.* It has no association with EBV (EBV negative).2) Mixed cellularity* It is the 2nd most common type overall, but the most common type of HD in India. It is more common in males and has biphasic age incidence (Bimodal age distribution), i.e. seen in young adults and in older age > 55 years.* Mononuclear variant along with clasical Reed-Sternberg cells are seen. RS cells are positive for CD 15 and CD 30.* It is associated with EBV (EBV positive).3) Lymphocyte rich* It is more common in males and is seen in older adults. It has frequent classical RS cells. RS cells are positive for CD 15 and CD 30. It is associated with EBV (EBVpositive). Prognosis is good to excellent.4) Lymphocyte depletion* It is more common in older males and HIV-infected individuals. Pleomorphic variants RS cells are seen, along with Hodgkin cells (atypical histiocytes). There is paucity of lymphocytes. It has maximum area of necrosis. Cells are positive for CD 15 and CD 30.* It has the worst prognosis. It is the least common type of HD.5) Lymphocytic predominance* It is more common in young males. Popcorn cells (Lympho-histocytic cells: L & H cells) are seen. Follicular dendritic cells are also seen. RS cells are positive for CD 20, but negative for CD 15 and CD 30.* It is not associated with EBV (EBV negative). It has the best prognosis. Mediastinal involvement may occur.
Mixed cellularity type
Nodular sclerotic type
Lymphocyte predominant type
Lymphocytic depletion type
Neoplasia