Hodgkin lymphoma - Revision history

Mark: fill in BCL6 and MUM1 in comparison table

2018-12-04T22:01:42Z

fill in BCL6 and MUM1 in comparison table

← Older revision		Revision as of 22:01, 4 December 2018
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	\|CD20 \|\| +ve \|\| -ve		\|CD20 \|\| +ve \|\| -ve
	\|-		\|-
	\|BCL6 \|\| \|\|		\|BCL6 \|\| +ve \|\| -ve
	\|-		\|-
	\|MUM1<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/601900 http://www.ncbi.nlm.nih.gov/omim/601900]. Accessed on: 10 August 2010.</ref> \|\| -ve \|\|		\|MUM1<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/601900 http://www.ncbi.nlm.nih.gov/omim/601900]. Accessed on: 10 August 2010.</ref> \|\| -ve \|\| +ve
	\|-		\|-
	\|CD30 \|\| -ve \|\| +ve (most sensitive).		\|CD30 \|\| -ve \|\| +ve (most sensitive).

Mark: /* Images (classic HL) */

2018-08-28T22:58:39Z

Images (classic HL)

← Older revision		Revision as of 22:58, 28 August 2018
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	Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)		Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
	Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)		Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
	Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \| Multinucleate RSC. (WC)		Image:16S14098 cHL multinucleate HRS cell x40c.jpg \| Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

Mark: correct image link again

2018-08-28T22:58:18Z

correct image link again

← Older revision		Revision as of 22:58, 28 August 2018
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	Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)		Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
	Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)		Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
	Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \|Multinucleate RSC. (WC)		Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \| Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

Mark: correct image name

2018-08-28T22:56:21Z

correct image name

← Older revision		Revision as of 22:56, 28 August 2018
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	Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)		Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
	Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)		Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
	Image:~~CHL~~ multinucleate cell ~~x40~~.jpg~~\|thumb~~\|Multinucleate RSC. (WC)		Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \|Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

Mark: more images

2018-08-28T22:54:38Z

more images

← Older revision		Revision as of 22:54, 28 August 2018
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	===Images (classic HL)===		===Images (classic HL)===
	<gallery>		<gallery>
			Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
			Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
			Image:CHL multinucleate cell x40.jpg\|thumb\|Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

Mark: more on IHC pattern

2018-06-24T21:19:54Z

Mark: few more tweaks

2018-06-23T16:31:18Z

few more tweaks

← Older revision		Revision as of 16:31, 23 June 2018
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	\| ClinDDx =		\| ClinDDx =
	}}		}}
	'''Hodgkin [[lymphoma]]''', abbreviated '''HL''', is a haematological [[malignancy]]. If not otherwise specified, Hodgkin lymphoma generally refers to classical Hodgkin lymphoma (~~cHL~~) rather than ~~less common~~ [[nodular lymphocyte-predominant Hodgkin lymphoma]] (NLPHL). The latter accounts for only about 5% of the loose label of Hodgkin lymphoma<ref name=Ref_WMSP567/> and shows a sufficiently different biology and immunophenotype that is essentially a different disease (see [[nodular lymphocyte-predominant Hodgkin lymphoma\|main article on NLPHL]]). The common feature is large atypical cells: Hodgkin/Reed-Sternberg cells in the case of classical Hodgkin lymphoma and "popcorn"/lymphohistiocytic/L&H cells in NLPHL. However, at least in typical cases, there are morphological and immunophenotypic differences.		'''Hodgkin [[lymphoma]]''', abbreviated '''HL''', is a haematological [[malignancy]]. If not otherwise specified, Hodgkin lymphoma generally refers to classical Hodgkin lymphoma (CHL) rather than [[nodular lymphocyte-predominant Hodgkin lymphoma]] (NLPHL). The latter accounts for only about 5% of the loose label of Hodgkin lymphoma<ref name=Ref_WMSP567/> and shows a sufficiently different biology and immunophenotype that is essentially a different disease (see [[nodular lymphocyte-predominant Hodgkin lymphoma\|main article on NLPHL]]). The common feature is large atypical cells: Hodgkin/Reed-Sternberg cells in the case of classical Hodgkin lymphoma and "popcorn"/lymphohistiocytic/L&H cells in NLPHL. However, at least in typical cases, there are morphological and immunophenotypic differences.

	Classical Hodgkin lymphoma has a bi-modal distribution, afflicting young adults and with a further peak in incidence in middle-age. Fortunately, it usually has a good prognosis.		Classical Hodgkin lymphoma has a bi-modal distribution, afflicting young adults and with a further peak in incidence in middle-age. Fortunately, it usually has a good prognosis.
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	==Gross==		==Gross==
	Location:		Location:
	*Almost always arises from a [[lymph node]] - classically in the neck.		*Almost always arises from a [[lymph node]] - classically in the neck, but may be in the axilla and mediastinum
	**''Extranodal Hodgkin lymphoma'' is (case report) rare.<ref name=pmid11100066>{{Cite journal \| last1 = Vadmal \| first1 = MS. \| last2 = LaValle \| first2 = GP. \| last3 = DeYoung \| first3 = BR. \| last4 = Frankel \| first4 = WL. \| last5 = Marsh \| first5 = WL. \| title = Primary localized extranodal hodgkin disease of the transverse colon. \| journal = Arch Pathol Lab Med \| volume = 124 \| issue = 12 \| pages = 1824-7 \| month = Dec \| year = 2000 \| doi = 10.1043/0003-9985(2000)1241824:PLEHDO2.0.CO;2 \| PMID = 11100066 }}</ref>		*Spleen may be involved
			*Bone marrow involvement is unusual (~5% of cases, higher in HIV-associated cases), so bone marrow assessment is usually not performed
			*''Extranodal Hodgkin lymphoma'' is (case report) rare.<ref name=pmid11100066>{{Cite journal \| last1 = Vadmal \| first1 = MS. \| last2 = LaValle \| first2 = GP. \| last3 = DeYoung \| first3 = BR. \| last4 = Frankel \| first4 = WL. \| last5 = Marsh \| first5 = WL. \| title = Primary localized extranodal hodgkin disease of the transverse colon. \| journal = Arch Pathol Lab Med \| volume = 124 \| issue = 12 \| pages = 1824-7 \| month = Dec \| year = 2000 \| doi = 10.1043/0003-9985(2000)1241824:PLEHDO2.0.CO;2 \| PMID = 11100066 }}</ref>

	==Microscopic==		==Microscopic==

	Defined by ''Reed-Sternberg cells'' (RSCs). Morphologically similar mononuclear cells are known as Hodgkin cells. RSCs are:		Defined by ''Reed-Sternberg cells'' (RSCs). Morphologically similar mononuclear cells are known as Hodgkin cells. RSCs are:
	*Large binucleated cell (>= 45 micrometres).<ref name=Ref_PCPBoD8_329>{{Ref PCPBoD8\|329}}</ref>		*Large binucleated cell (>= 45 micrometres).<ref name=Ref_PCPBoD8_329>{{Ref PCPBoD8\|329}}</ref>
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	*[[Diffuse large B cell lymphoma]] (DLBCL), esp. ''T-cell/histiocytic-rich LBCL''.		*[[Diffuse large B cell lymphoma]] (DLBCL), esp. ''T-cell/histiocytic-rich LBCL''.
	*[[Anaplastic large cell lymphoma]] (ALCL).		*[[Anaplastic large cell lymphoma]] (ALCL).
	*B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma.<ref name=pmid22222636>{{Cite journal \| last1 = Gualco \| first1 = G. \| last2 = Natkunam \| first2 = Y. \| last3 = Bacchi \| first3 = CE. \| title = The spectrum of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma: a description of 10 cases. \| journal = Mod Pathol \| volume = \| issue = \| pages = \| month = Jan \| year = 2012 \| doi = 10.1038/modpathol.2011.200 \| PMID = 22222636 \| URL = http://www.nature.com/modpathol/journal/vaop/ncurrent/full/modpathol2011200a.html }}</ref>		*B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma.<ref name=pmid22222636>{{Cite journal \| last1 = Gualco \| first1 = G. \| last2 = Natkunam \| first2 = Y. \| last3 = Bacchi \| first3 = CE. \| title = The spectrum of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma: a description of 10 cases. \| journal = Mod Pathol \| volume = \| issue = \| pages = \| month = Jan \| year = 2012 \| doi = 10.1038/modpathol.2011.200 \| PMID = 22222636 \| URL = http://www.nature.com/modpathol/journal/vaop/ncurrent/full/modpathol2011200a.html }}</ref> (typically in cases of numerous large atypical cells where the morphology and immunophenotype do not neatly fit into either DLBCL or CHL).

	==IHC==		==IHC==

Mark: a few other points

2018-06-23T16:21:19Z

a few other points

← Older revision		Revision as of 16:21, 23 June 2018
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	==Microscopic==		==Microscopic==
	~~By definition, HL has ''Reed-Sternberg cells'' (RSCs) or ''Popcorn cells''.~~

	~~===Classical HL===~~		Defined by ''Reed-Sternberg cells'' (RSCs). Morphologically similar mononuclear cells are known as Hodgkin cells. RSCs are:
	~~Features (classic HL):~~		*Large binucleated cell (>= 45 micrometres).<ref name=Ref_PCPBoD8_329>{{Ref PCPBoD8\|329}}</ref>
	*Reed-Sternberg ~~cell~~.		**May be multinucleated.
	**Large binucleated cell (>= 45 micrometres).<ref name=Ref_PCPBoD8_329>{{Ref PCPBoD8\|329}}</ref>		**May have a horseshoe-like shape.
	***May be multinucleated.		*[[Macronucleolus]] - approximately the size of a RBC (~8 micrometers).
	***May have a horseshoe-like shape.		*Well-defined cell border.
	**[[Macronucleolus]] - approximately the size of a RBC (~8 micrometers).		*Abundant cytoplasm.
	**Well-defined cell border.
	**Abundant cytoplasm.

	~~Notes:~~		RSC may show peri-cellular clearing, making the cells appear within a space. These are called lacunar cells (as they are in a "lake"). Apoptotic RSC may show pyknotic nuclei and scant eosinophilic cytoplasm and are sometimes known as "mummified" cells.
	*Large mononuclear cells are ~~common~~ (~~so called~~ "~~mononuclear RSCs~~") ~~but not diagnostic~~.

	====Images (classic HL)====		===Images (classic HL)===
	<gallery>		<gallery>
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
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	*CD30 Reed-Sternberg cells (RSCs) +ve ~98%		*CD30 Reed-Sternberg cells (RSCs) +ve ~98%
	*CD15 Reed-Sternberg cells +ve ~80%, stains neutrophils.		*CD15 Reed-Sternberg cells +ve ~80%, stains neutrophils.
			*MUM1 +ve
	*CD45 '''often negative''' in RSCs.		*CD45 '''often negative''' in RSCs.
	*CD20 may stain RSCs.		*CD20 may stain RSCs (usually negative, but can be weak).
	*PAX5 +ve.<ref name=Ref_APBR683>{{Ref APBR\|683}}</ref>		*PAX5 +ve.<ref name=Ref_APBR683>{{Ref APBR\|683}}</ref>

	Additional - for completeness:		Additional - for completeness:
	*CD3 (T lymphocytes)		*CD3 (T lymphocytes)
			*40% are EBV positive.

	NLPHL IHC '''differs''' from the classical HL:<ref name=Ref_APBR683>{{Ref APBR\|683}}</ref>		NLPHL IHC '''differs''' from the classical HL:<ref name=Ref_APBR683>{{Ref APBR\|683}}</ref>
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	*CD10 +ve.		*CD10 +ve.
	*Bcl-6 +ve.		*Bcl-6 +ve.
	*[[EMA]] +ve.		*[[EMA]] +ve (40-50%)
	*CD30 -ve		*CD30 -ve
	*CD15 -ve.		*CD15 -ve.

Mark: Separate page for NLPHL

2018-06-23T16:07:34Z

Separate page for NLPHL

← Older revision		Revision as of 16:07, 23 June 2018
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	\| ClinDDx =		\| ClinDDx =
	}}		}}
	~~{{ Infobox diagnosis~~		'''Hodgkin [[lymphoma]]''', abbreviated '''HL''', is a haematological [[malignancy]]. If not otherwise specified, Hodgkin lymphoma generally refers to classical Hodgkin lymphoma (cHL) rather than less common [[nodular lymphocyte-predominant Hodgkin lymphoma]] (NLPHL). The latter accounts for only about 5% of the loose label of Hodgkin lymphoma<ref name=Ref_WMSP567/> and shows a sufficiently different biology and immunophenotype that is essentially a different disease (see [[nodular lymphocyte-predominant Hodgkin lymphoma\|main article on NLPHL]]). The common feature is large atypical cells: Hodgkin/Reed-Sternberg cells in the case of classical Hodgkin lymphoma and "popcorn"/lymphohistiocytic/L&H cells in NLPHL. However, at least in typical cases, there are morphological and immunophenotypic differences.
	~~\| Name = Nodular lymphocyte-predominant~~ Hodgkin ~~lymphoma~~
	~~\| Image = Popcorn_cell_in_nodular_lymphocyte_predominant_Hodgkin_lymphoma_-_very_high_mag_cropped.jpg~~		Classical Hodgkin lymphoma has a bi-modal distribution, afflicting young adults and with a further peak in incidence in middle-age. Fortunately, it usually has a good prognosis.
	~~\| Width =~~
	~~\| Caption = Popcorn cell in nodular lymphocyte-predominant Hodgkin lymphoma~~
	~~\| Micro = Popcorn cells (relatively) small (compared to classic RSCs) - have lobulated nucleus (key feature), small nucleoli; subtle nodularity at low power~~
	~~\| Subtypes = none~~
	~~\| LMDDx =~~ [[~~diffuse large B cell~~ lymphoma]] ~~(esp.~~ ''~~T-cell/histiocytic-rich LBCL~~''), [[~~anaplastic large cell lymphoma~~]],
	~~B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical~~ Hodgkin lymphoma, classical Hodgkin lymphoma
	~~\| Stains =~~
	~~\| IHC = LCA~~ (~~CD45~~) ~~+ve, CD20 +ve, CD10 +ve, Bcl-6 +ve, EMA +ve, CD30 -ve, CD15 -ve~~
	~~\| EM =~~
	~~\| Molecular =~~
	~~\| IF =~~
	~~\| Gross =~~
	~~\| Grossing =~~
	~~\| Site = usu.~~ [[~~lymph node~~]]
	~~\| Assdx =~~
	~~\| Syndromes =~~
	~~\| Clinicalhx =~~
	~~\| Signs = lymphadenopathy~~
	~~\| Symptoms =~~
	~~\| Prevalence = uncommon~~
	~~\| Bloodwork =~~
	~~\| Rads =~~
	~~\| Endoscopy =~~
	~~\| Prognosis = good~~
	~~\| Other =~~
	~~\| ClinDDx =~~
	}}
	~~'''~~Hodgkin [[lymphoma~~]]''', abbreviated '''HL''',~~ is a [[~~malignancy~~]] ~~that often afflicts people~~ in the ~~prime~~ of ~~their life~~. Fortunately, it usually has a good prognosis.

	Pathologists say "... it is both the easiest and hardest diagnosis to make." The reason for this is: the diagnosis depends on finding Reed-Sternberg cells (or Popcorn cells); if they are obvious the diagnosis is easy... if you can't find 'em and an alternative diagnosis is not apparent -- you wonder whether you're missing them.		Pathologists say "... it is both the easiest and hardest diagnosis to make." The reason for this is: the diagnosis depends on finding Reed-Sternberg cells (or Popcorn cells); if they are obvious the diagnosis is easy... if you can't find 'em and an alternative diagnosis is not apparent -- you wonder whether you're missing them.
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	*Usually good.		*Usually good.
	*Unlike non-Hodgkin lymphomas, it spreads in a predictable pattern; thus, staging plays an important role in determining the therapy.<ref name=PCPBoD8_315>{{Ref PCPBoD8\|315}}</ref>		*Unlike non-Hodgkin lymphomas, it spreads in a predictable pattern; thus, staging plays an important role in determining the therapy.<ref name=PCPBoD8_315>{{Ref PCPBoD8\|315}}</ref>
			*Clinically classified into early favourable, early unfavourable and late/advanced disease.

	==~~Hodgkin lymphoma subtypes~~==		===Classic HL sub-types===
	~~Types~~:<ref name=Ref_WMSP567/>		====Subtypes of classic HL====
	*Classical HL (CHL) - ~95% of HL.		There are four CHL subtypes:<ref name=Ref_WMSP567/>
	*Nodular ~~lymphocyte~~-~~predominant HL (NLPHL)~~ - ~5% of HL.		#Nodular sclerosis CHL - ~70% of CHL.
			#*Mixed cellular background - T cell, plasma cells, eosinophils, neutrophils and histiocytes.
			#*Nodular sclerosing fibrosis - thick strands fibrosis.
			#Mixed cellularity CHL - ~20-25% of CHL.
			#*Like nodular sclerosis - but no fibrosis.
			#*May be associated with [[HIV]] infection.<ref name=pmid20138008>{{cite journal \|author=Sissolak G, Sissolak D, Jacobs P \|title=Human immunodeficiency and Hodgkin lymphoma \|journal=Transfus. Apher. Sci. \|volume=42 \|issue=2 \|pages=131–9 \|year=2010 \|month=April \|pmid=20138008 \|doi=10.1016/j.transci.2010.01.008 \|url=}}</ref>
			#Lymphocyte-rich CHL - rare.
			#*T lymphocytes only (no mix of cells).
			#Lymphocyte-depleted CHL - rare.
			#*May be associated with HIV infection.<ref name=pmid20138008/>

	~~===Classic HL===~~		Memory device:
	*Four types of classic HL (see below).		*The subtypes prevalence is in reverse alphabetical order.

	~~===NLPHL===~~
	*AKA ''lympho-histiocytic variant''.
	*Abbreviated ''NLPHL''.
	*Different IHC and morphologic appearance than classic HL.
	*~~Significant risk for transformation into [[diffuse large B cell lymphoma]] (DLBCL); 10-year cumulative transformation rate (to DLBCL)~~ in one study was 12%.<ref name=pmid20029973 >{{cite journal \|author=Biasoli I, Stamatoullas A, Meignin V, ''et al.'' \|title=Nodular, lymphocyte-predominant Hodgkin lymphoma: a long-term study and analysis of transformation to diffuse large B-cell lymphoma in a cohort of 164 patients from the Adult Lymphoma Study Group \|journal=Cancer \|volume=116 \|issue=3 \|pages=631–9 \|year=2010 \|month=February \|pmid=20029973 \|doi=10.1002/cncr.~~24819 \|url=}}</ref>~~

	==Gross==		==Gross==
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	Image:Hodgkin_lymphoma_%281%29_mixed_cellulary_type.jpg \| HL mixed cellularity. (WC)		Image:Hodgkin_lymphoma_%281%29_mixed_cellulary_type.jpg \| HL mixed cellularity. (WC)
	</gallery>		</gallery>
	~~====Subtypes of classic HL====~~
	~~There are four CHL subtypes:<ref name=Ref_WMSP567/>~~
	~~#Nodular sclerosis CHL - ~70% of CHL.~~
	~~#*Mixed cellular background - T cell, plasma cells, eosinophils, neutrophils and histiocytes.~~
	~~#*Nodular sclerosing fibrosis - thick strands fibrosis.~~
	~~#Mixed cellularity CHL - ~20-25% of CHL.~~
	~~#*Like nodular sclerosis - but no fibrosis.~~
	#*May be associated with [[HIV]] infection.<ref name=pmid20138008>{{cite journal \|author=Sissolak G, Sissolak D, Jacobs P \|title=Human immunodeficiency and Hodgkin lymphoma \|journal=Transfus. Apher. Sci. \|volume=42 \|issue=2 \|pages=131–9 \|year=2010 \|month=April \|pmid=20138008 \|doi=10.1016/j.transci.2010.01.008 \|url=}}</ref>
	~~#Lymphocyte-rich CHL - rare.~~
	~~#*T lymphocytes only (no mix of cells).~~
	~~#Lymphocyte-depleted CHL - rare.~~
	~~#*May be associated with HIV infection.<ref name=pmid20138008/>~~

	~~Memory device:~~
	*The subtypes prevalence is in reverse alphabetical order.

	~~===Nodular lymphocyte predominant Hodgkin lymphoma===~~
	~~Features (nodular lymphocyte-predominant Hodgkin's lymphoma):~~
	*''Popcorn cell'' (previously known as ''Lymphocytic & histiocytic'' cell (L&H cell)<ref name=pmid9499174>{{cite journal \|author=Küppers R, Rajewsky K, Braeuninger A, Hansmann ML \|title=L&H cells in lymphocyte-predominant Hodgkin's disease \|journal=N. Engl. J. Med. \|volume=338 \|issue=11 \|pages=763–4; author reply 764–5 \|year=1998 \|month=March \|pmid=9499174 \|doi=10.1056/NEJM199803123381113 \|url=}}</ref>) - variant of RSC:
	**Cells (relatively) small (compared to classic RSCs).
	**Lobulated nucleus - '''key feature'''.
	**Small nucleoli.
	*Subtle nodularity at low power (2.5x or 5x objective).

	~~====Images (NLPHL)====~~
	~~www:~~
	*[http://webpathology.com/image.asp?case=388&n=16 Popcorn cell (webpathology.com)].
	~~<gallery>~~
	~~Image:Popcorn_cell_in_nodular_lymphocyte_predominant_Hodgkin_lymphoma_-_very_high_mag_cropped.jpg \| Popcorn cell. (WC)~~
	~~</gallery>~~
	===DDx both CHL & NLPHL===		===DDx both CHL & NLPHL===
	*CHL/NLPHL.		*CHL/NLPHL.

Michael: /* See also */

2016-12-07T16:51:07Z

← Older revision		Revision as of 22:58, 28 August 2018
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	Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)		Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
	Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)		Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
	Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \| Multinucleate RSC. (WC)		Image:16S14098 cHL multinucleate HRS cell x40c.jpg \| Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

← Older revision		Revision as of 22:58, 28 August 2018
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	Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)		Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
	Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)		Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
	Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \|Multinucleate RSC. (WC)		Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \| Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

← Older revision		Revision as of 22:56, 28 August 2018
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	Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)		Image:CHL mummified cell x40.jpg \| "Mummified" RSC. (WC)
	Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)		Image:CHL lacunar cell x40.jpg \| "Lacunar cell". (WC)
	Image:~~CHL~~ multinucleate cell ~~x40~~.jpg~~\|thumb~~\|Multinucleate RSC. (WC)		Image:16S14098 cHL multinucleate HRS cell x40c.jpg. \|Multinucleate RSC. (WC)
	Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_large.jpg \| HL mixed cellularity - cytology. (WC)
	Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)		Image:Hodgkin_lymphoma_cytology_small.jpg \| HL mixed cellularity - cytology. (WC)

← Older revision		Revision as of 16:51, 7 December 2016
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	\|4 unstained \|\| \|\|		\|4 unstained \|\| \|\|
	\|}		\|}

			==Sign out==
			===Suggestive FNA===
			<pre>
			Lymph Node, Right Neck, FNA:
			- Large binucleated and multinucleated cells with macronucleoli in
			a background of abundant lymphocytes, histiocytes, rare eosinophils.

			Comment:
			A cell block is not available for further work-up. The findings raise the possibility of Hodgkin's lymphoma.

			A further biopsy is required for the diagnosis.
			</pre>

	==See also==		==See also==

← Older revision		Revision as of 21:19, 24 June 2018
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	==IHC==		==IHC==
	Abbreviated panel:<ref name=Ref_WMSP568>{{Ref_WMSP\|568}}</ref>		Abbreviated panel:<ref name=Ref_WMSP568>{{Ref_WMSP\|568}}</ref>
	*CD30 Reed-Sternberg cells (RSCs) +ve ~98%		*CD30 Reed-Sternberg cells (RSCs) +ve ~98% (beware of mis-interpreting CD30+ activated lymphoid cells)
	*CD15 Reed-Sternberg cells +ve ~80%, stains neutrophils.		*CD15 Reed-Sternberg cells +ve ~80%, stains neutrophils.
			*Both CD30 and CD15 are classically positive in a membranous and Golgi pattern
	*MUM1 +ve		*MUM1 +ve
	*CD45 '''often negative''' in RSCs.		*CD45 '''often negative''' in RSCs.
	*CD20 may stain RSCs (usually negative, but can be weak).		*CD20 may stain RSCs (usually negative, but can be weak).
	*PAX5 +ve.<ref name=Ref_APBR683>{{Ref APBR\|683}}</ref>		*PAX5 +ve, though said to be weaker than background normal B-cells<ref name=Ref_APBR683>{{Ref APBR\|683}}</ref>

	Additional - for completeness:		Additional - for completeness:
	*CD3 (T lymphocytes)		*CD3 (T lymphocytes) - negative in RSCs
			*OCT2/BOB1 negative (co-transcription factors for immunoglobulin production, one or the other is usually negative)
	*40% are EBV positive.		*40% are EBV positive.