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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
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated