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Hodgkin Lymphoma (Mixed Cellularity) Involving the Bone Marrow

View larger version (158K): [in this window] [in a new window]   Figure 1. 47 y.o. male with known diagnosis of mixed cellularity classical Hodgkin lymphoma underwent a bone marrow biopsy for staging. This low power view shows complete replacement of the marrow by lymphoma with total absence of normal hematopoietic elements. (H&E 4x)

View larger version (182K): [in this window] [in a new window]   Figure 2. A higher power view of the same area shows a polymorphous infiltrate consisting primarily of small lymphocytes, eosinphils, scattered plasma cells, and macrophages. Within this infiltrate are large mononuclear cells with abundant cytoplasm and nuclei with irregular borders, some containing large single azurophilic nucleolus. Nuclei in some cells are multilobated; others have an anaplastic appearance. These cells represent a spectrum of Reed-Sternberg cells. (H&E 10x)

View larger version (155K): [in this window] [in a new window]   Figure 3. At still higher power the cellular constituents are more apparent. A classical R-S cell is present in the upper R corner of the slide, while an anaplastic forms can be seen in the center of the slide and in the upper L corner of the slide. Eosinophils, lymphocytes, mast cells and macrophages are abundant.(H&E 40x)

View larger version (157K): [in this window] [in a new window]   Figure 4. The heterogeneity in the morphology of the R-S cells is shown again in this view of the infiltrate. Note the large azurophilic nucleoli in many of the cells. (H&E 40x)

View larger version (185K): [in this window] [in a new window]   Figure 5. This slide illustrates the large number of R-S cells in the polymorphous infiltrate and the morphologic variation of these cells. (H&E 10x)

View larger version (164K): [in this window] [in a new window]   Figure 6. A CD30 immunohistochemical stain highlights the numerous R-S cells in the infiltrate. (H&E 10x)

View larger version (164K): [in this window] [in a new window]   Figure 7. At a higher power view of the previous slide, the staining pattern of the R-S cell with CD30 antibody shows both the cytoplasmic membranes and Golgi regions to be positive. This is the classical pattern for R-S cell with this antibody. (H&E 40x)

View larger version (93K): [in this window] [in a new window]   Figure 8. The marrow was inaspirable; however, a touch preparation of the marrow biopsy shows two large mononuclear cells in the lower portion of the slide. These cells were suggestive of R-S cells. (Wright-Giemsa 10x)

View larger version (142K): [in this window] [in a new window]   Figure 9. Touch prep: A higher power of the previous slide shows the upper cells to contain two large basophilic nucleoli, while the lower cell appears to contain two distinct large nuclei. These cells are morphologically similar to the R-S cells noted on the marrow biopsy images previously shown. (Wright-Giemsa 40x)

View larger version (129K): [in this window] [in a new window]   Figure 10. Touch prep: The morphology of the binucleated large R-S cell is shown more clearly in this view of the lower cell seen in the previous image. The cell is similar to the binucleated R-S cells seen on the biopsy images. (Wright-Giemsa 100x)

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Hodgkin Lymphoma (Hodgkin's Disease) Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?