Popcorn Reed-Sternberg cells are characteristically seen in which type of Hodgkin&;s lymphoma?
Ans. b (Lymphocyte predominant) (Ref. Robbin's pathology 7th/ Fig. 14-23; 688) Popcorn Reed-Sternberg cells are characteristically seen in Lymphocyte predominant variety of HD. HD Features Hodgkin lymphoma, nodular sclerosis type # Shows well-defined bands of pink, acellular collagen that subdivide the tumor cells and associated reactive infiltrate into nodules. Hodgkin lymphoma, mixed cellularity type # A diagnostic, binucleate Reed-Sternberg cell is surrounded by reactive cells, including eosinophils (bright red cytoplasm), lymphocytes, and histiocytes. Hodgkin lymphoma, lymphocyte predominance type # Numerous mature-looking lymphocytes surround scattered, large, pale-staining L&H variants ("popcorn" cells). Classical forms of Hodgkin lymphoma # Proposed signals mediating "cross-talk" between Reed-Sternberg cells and surrounding normal cells. REED-STERNBERG CELLS AND VARIANTS #Diagnostic Reed-Sternberg cell, with two nuclear lobes, large inclusion-like nucleoli, and abundant cytoplasm, surrounded by lymphocytes, macrophages, and an eosinophil. #Reed-Sternberg cell, mononuclear variant. #Reed-Sternberg cell, the lacunar variant is characteristic of the nodular sclerosis subtype. #Reed-Sternberg cell, lymphohistiocytic (L&H) variant. Several such variants are present with complex nuclear irregularities, small nucleoli, fine chromatin, and abundant pale cytoplasm. Subtype Morphology and Immunophenotype Typical Clinical features Nodular sclerosis Frequent lacunar cells and occasional diagnostic R-S cells; background infiltrate composed of T lymphocytes, eosinophils, macrophages and plasma cells; fibrous bands dividing cellular areas into nodules. R-S cells CD15+, CD30+; EBV Stage 1 or 2 diseases most common Frequent mediastinal involvement F = M, most patients young adults Mixed cellularity Frequent mononuclear and diagnostic R-S cells; background infiltrate rich in T-cells, eosinophils, macrophages, plasma cells, R-S cells CD15+, CD 30+; 70% EBV+. > 50% present as stage 3 or 4 diseases. M > F. Biphasic incidence, peaking in young adults and again in adults older than 55. Lymphocyte-rich Frequent mononuclear and diagnostic R-S cells; background infiltrate rich in T lymphocytes. R-S cells CD15+, CD30+; 40% EBV Uncommon. M > F; seen in older adults Lymphocyte depletion Reticular variant: Frequent diagnostic R-S cells and variants with a paucity of background reactive cells; diffuse fibrosis variant; hypocellular fibrillar background with scattered diagnostic R-S cells and variants and few reactive cells. R-S cells CD15+, CD30+; most EBV+. Uncommon. More common in older males, HIV infected individuals, and in developing countries. More likely to present with advanced disease. Lymphocyte predominance Frequent L & H (popcorn cell) variants in a background of follicular dendritic cells and reactive B cells, R-S cells CD20+, CD 15-, CD30-; EBV-. Uncommon. Young males with cervical or axillary lymphadenopathy. Mediastinal.
Nodular sclerosis
Lymphocyte predominant
Lymphocyte depleted
Mixed cellularity