Hodgkin's lymphoma pathophysiology: Difference between revisions

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==Pathophysiology==
==Pathophysiology==
[[Image:Reed-Sternberg (Hodgkin's Lymphoma).jpg|thumb|left|Reed-Sternberg Hodgkin's Lymphoma<ref>http://picasaweb.google.com/mcmumbi/USMLEIIImages</ref>]]
 


====Gross Pathology====
====Gross Pathology====
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====Microscopic Pathology====
====Microscopic Pathology====
Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual [[CD45]]-, [[CD30]]+, [[CD15]]+/- immunophenotype.  In approximately 50% of cases, the Reed-Sternberg cells are infected by the [[Epstein-Barr]] [[virus]].
Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual [[CD45]]-, [[CD30]]+, [[CD15]]+/- immunophenotype.  In approximately 50% of cases, the Reed-Sternberg cells are infected by the [[Epstein-Barr]] [[virus]].
<gallery widths=200px>
Image:Reed-Sternberg (Hodgkin's Lymphoma).jpg|Reed-Sternberg Hodgkin's Lymphoma<ref>http://picasaweb.google.com/mcmumbi/USMLEIIImages</ref>
Image:197px-Hodgkin lymphoma cytology large.jpg|Micrograph showing Hodgkin lymphoma (Field stain)
Image:199px-Popcorn cell in nodular lymphocyte predominant Hodgkin lymphoma - very high mag cropped.jpg|Micrograph showing a "popcorn cell", the Reed–Sternberg cell variant seen in nodular lymphocyte predominant Hodgkin lymphoma. H&E stain
</gallery>


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Revision as of 19:36, 4 September 2015

Hodgkin's lymphoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Pathophysiology

Gross Pathology

Affected lymph nodes (most often, laterocervical lymph nodes) are enlarged, but their shape is preserved because the capsule is not invaded. Usually, the cut surface is white-grey and uniform; in some histological subtypes (e.g. nodular sclerosis) may appear a nodular aspect

Microscopic Pathology

Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual CD45-, CD30+, CD15+/- immunophenotype. In approximately 50% of cases, the Reed-Sternberg cells are infected by the Epstein-Barr virus.



Reed-Sternberg cells (RSC) (Classical and variants)
Type of cell Characteristics
Classic
Reed-Sternberg cells (RSC) Include large size (20–50 micrometres), abundant, amphophilic, finely granular/homogeneous cytoplasm; two mirror-image nuclei (owl eyes) each with an eosinophilic nucleolus and a thick nuclear membrane (chromatin is distributed close to the nuclear membrane).
Variants
Hodgkin cell (Atypical mononuclear Reed-Sternberg cell) has the same characteristics as Reed-Sternberg cells (RSC), but is mononucleated.
Lacunar Reed-Sternberg cells Are large, with a single hyperlobulated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space ("lacunae").
Pleomorphic Reed-Sternberg cells Has multiple irregular nuclei.
"Popcorn" Reed-Sternberg cells (Lympho-histiocytic variant) is a small cell, with a very lobulated nucleus, small nucleoli.
"Mummy" Reed-Sternberg cells Has a compact nucleus with no nucleolus and basophilic cytoplasm.

References


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