Secondary Lymphoid Tissues ›› Lymph Node ›› Neoplastic: Hodgkin Lymphoma

Classical Hodgkin Lymphoma*


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› Microscopic Features:

• The lymph node is usually effaced (closed subcapsular sinus and loss of normal follicle architecture)
• Background is usually Lymphohistiocytic (mix of small lymphocytes and larger histiocytes with abundant pink cytoplasm)
• Scattered background neoplastic cells are the Reed-Sternberg (RS) cells (2 or more nuclei with very large nucleoli) and Hodgkin cells (single large nucleus with large nucleolus)

› Normal % blood-PB, marrow-BM, lymphoid tissue-LN:

• PB: N/A
• BM: N/A
• LN: N/A

› May Resemble:

• Non-neoplastic reactive Lymph node [Compare]
• Follicular Lymphoma [Compare]
• Diffuse Large B-cell Lymphoma (esp. the T-cell/Histiocyte Rich Large B-cell Lymphoma subtype)

› Differential Diagnoses:

Diffuse Large B-cell Lymphoma (esp. The T-cell/Histiocyte Rich Large B-cell Lymphoma subtype) Non-neoplastic reactive Lymph node Follicular Lymphoma

› Classic Immunophenotype:

• RS cells: CD30+, CD15+/-, PAX5 dim+ (a B-cell marker), and most are OCT2, BOB1 and CD20 negative
• Also, as opposed to most hematopoietic cells which are CD45+, RS cells are CD45 negative (CD45 is also known as LCA or Leukocyte Common Antigen)

› Misc:

• Hodgkin usually presents in supra diaphragmatic lymph nodes or lymphoid areas Usually thought to be EBV associated Classical Hodgkin Lymphoma has 4 subtypes: Nodular Sclerosing, Mixed Cellularity, Lymphocyte-Rich, and Lymphocyte depleted.