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Cytopathology: LC06-1 HODGKIN LYMPHOMA: DIAGNOSTIC CRITERIA AND PITFALLS.
[hodgkin lymphoma, classical]
The
histopathological
and
fine-needle
aspiration
(
FNA
)
cytologic
diagnosis
of
Hodgkin
lymphoma
(
HL
)
is
based
on
demonstration
of
pathognomonic
mononucleated
Hodgkin
and
bi
-
to
multinucleated
Reed
-
Sternberg
(
HRS
)
cells
among
reactive
cellular
components
composed
of
lymphocytes
,
benign
histiocytes
,
neutrophils
and
eosinophils
.
In
the
WHO
classification
,
Hodgkins
lymphoma
is
classified
as
nodular
lymphocytic
predominant
HL
(
NLPHL
)
and
classical
HL
which
is
in
turn
sub-classified
into
lymphocyte-rich
(
LR
)
,
mixed
cellular
(
MC
)
,
lymphocytic
depleted
(
MC
)
and
nodular
sclerosis
(
NS
)
types
.
The
sub-classification
of
classical
HL
into
LR
,
MC
,
and
LD
depends
on
relative
proportions
of
neoplastic
HRS
cells
and
reactive
cellular
components
.
Whereas
in
HL-
NS
shows
a
special
type
of
R-S
cells
called
lacunar
cells
,
NLPHL
is
characterized
by
popcorn
cells
.
CHL-
MC
to
some
extent
and
other
HL
subtypes
to
a
large
extent
may
pose
diagnostic
challenges
in
the
cytologic
material
.
Reed
-
Sternberg-like
cells
have
been
reported
in
benign
lympho-proliferative
conditions
like
reactive
hyperplasia
and
infectious
mononucleosis
,
and
certain
of
non-
Hodgkin
lymphoma
subtypes
as
well
as
non-lymphoid
malignancies
like
metastatic
carcinoma
,
melanoma
,
sarcomas
and
germ
cell
tumors
.
Non-
Hodgkin
lymphoma
subtypes
,
e
.
g
.
,
anaplastic
large
cell
lymphoma
,
T
-
cell-histiocytic-rich
B-
cell
lymphoma
,
and
pleomorphic
peripheral
T-
cell
lymphoma
,
which
can
be
misdiagnosed
as
Hodgkin
lymphoma
,
need
immunohistochemical
studies
to
be
differentiated
.
Diseases
Validation
Diseases presenting
"nodular sclerosis"
symptom
hodgkin lymphoma, classical
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