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

Classical Hodgkin Lymphoma*






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
  • Follicular Lymphoma
  • 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.