Which of the following features is shared in common between lymphocyte-rich and lymphocyte-predominant types of Hodgkin's lymphoma?
Ans. d (Prognosis is excellent) (Ref. Robbins 7th/689)Paragraph from Robbins Pathology 7th ed. p. 688, Table 14-6:Lymphocyte-rich:Lymphocyte predominance:# Frequent mononuclear & R-S cells0# Paucity of RS cells # 40% EBV+.Q# R-S cells CD20+, CD15-, C30-;# CD20 and CD 45-Q# EBV--Q.# Very good to excellent prognosis.# Excellent prognosis QPathological features of Types of NHLSubtypeMorphology and immunophenotypeTypical clinical featuresNodular sclerosis# Most common type (65-70%)# R-S cells CD15+, CD30+; CD 45-# Frequent mediastinal involvement, diagnostic R-S cells;# EBV-.# B and T cell markers-# Excellent prognosis# Stage 1 or 2 disease most common.# Frequent lacunar cells and occasional# F = M, most patients young adults# Background infiltrate composed of T-cells, eosinophils, macrophages and plasma cells with fibrous bands dividing cellular areas into nodules.Mixed cellularity# 20-25%# Diffuse effacement of nodes# Frequent mononuclear and RS cells# R-S cells CD15+, CD30+;# Background infiltrate rich in T lymphocytes, eosinophils, macrophages, plasma ceils;- 70% EBV+,# More than 50% present as stage 3 or 4 disease.# M > F.# Biphasic incidence, peaking in young adults and again in adults > 55 yrs.Lymphocyte-rich# Uncommon# Frequent mononuclear and diagnostic R-S cells;# Background infiltrate rich in T-cells# R-S cells CD15+, CD30+;# 40% EBV+.Q# CD20 and CD 45-Q# Very good to excellent prognosis.# Uncommon.# M > F.# Tends to be seen in older adults.Lymphocyte depletion# Least common (< 5%)# 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 ceils.# 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.# Less favourable outcome.Lymphocyte predominance# Uncommon (5%)# Frequent Lymphohistiocytic (popcorn cell) variants in a background of follicular dendritic cells and reactive B cells,# Paucity of RS cells# R-S cells CD20+, CD15-, C30-;# EBV-.# Excellent prognosis # Uncommon.# Young males with cervical or axillary lymphadenopathy. Mediastinal.
Paucity of diagnostic RS cells
EBV is associated in 40% of cases
RS cells are CD20 positive
Prognosis is excellent
Blood