Page 386 - Textbook of Pathology, 6th Edition

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SECTION II

Figure 14.16 Microscopic features of 4 forms of Hodgkin’s disease of lymph node. The inset on right side of each type shows the morphologic
variant of RS cell seen more often in particular histologic type.

Haematology and Lymphoreticular Tissues
the number of lymphocytes in a particular histologic subtype MORPHOLOGIC FEATURES. Grossly, the gross
of HD. appearance of Hodgkin’s and non-Hodgkin’s lymphoma
Immunophenotyping of RS cells reveals monoclonal is much the same. Any lymph node group may be
lymphoid cell origin of RS cell from B-cells of the germinal involved but most commonly affected are the cervical,
centre in most subtypes of Hodgkin’s disease. RS cells in all supraclavicular and axillary groups. Initially, the lymph
types of Hodgkin’s diseases, except in lymphocyte predomi- nodes are discrete and separate from one another but later
nance type, express immunoreactivity for CD15 and CD30 the lymph nodes form a large matted mass due to
(Fig. 14.17). RS cells in lymphocyte predominance type, infiltration into the surrounding connective tissue.
however, are negative for both CD15 and CD30, but positive Extranodal involvements produce either a discrete tumour
for CD20. or diffuse enlargement of the affected organ. The sectioned
RS cells are invariably accompanied by variable number surface of the involved lymph nodes or extranodal organ
of atypical Hodgkin cells which are believed to be precursor involved appears grey-white and fishflesh-like. Nodular
RS cells but are not considered diagnostic of HD. Hodgkin sclerosis type HD may show formation of nodules due to
cells are large mononuclear cells (rather than mirror image scarring while mixed cellularity and lymphocyte depletion
nuclei) having nuclear and cytoplasmic similarity to that of types HD may show abundance of necrosis. Lympho-
RS cell.