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Hodgkin Lymphoma : Lymph Node Biopsy

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Lymph Node Biopsy for Hodgkin Lymphoma: Excisional biopsy of an enlarged lymph node is the gold standard for establishing the diagnosis of classic Hodgkin lymphoma (cHL). Deep-seated lymph nodes or masses can be sample by core needle biopsy. Care must be taken to ensure sufficient material for morphologic as well as immunophenotypic analysis. Fine needle aspirations are not recommended due to potential for false negative results.

The diagnosis depends on finding diagnostic Hodgkin and Reed-Sternberg (HRS) cells in the context of a tumor microenvironment consisting of immune effector cells (T- and B-cells, eosinophils, neutrophils, histiocytes, and plasma cells). The HRS variants, including lacunar cells and mononuclear variants, can help identify histologic subtypes of cHL.

The HRS cells have a unique immunophenotype as follows: CD30+, CD15+ (75%-85%), CD45-, and weak/inconsistent/heterogenous expression of B-cell and T-cell markers in a small percentage of cells.

This gross specimen photograph shows nodular sclerosis classic Hodgkin lymphoma in an enlarged cervical lymph node in a young male.

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