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Nodular Sclerosis Hodgkin Lymphoma

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Four subtypes of classic Hodgkin lymphoma (cHL) are currently recognized based on the tissue architecture, morphology of the neoplastic cells, and characteristics of the background reactive immune cells. They are:

  • nodular sclerosis (70%)
  • mixed cellularity (25%)
  • lymphocyte predominant (5%)
  • lymphocyte depleted (<1%)

  • In about 5% of cHL cases, a subtype cannot be specified, usually due to insufficient material available for complete analysis.

    Nodular sclerosis is the most common subtype of cHL. Grossly, the involved lymph node is firm due to fibrosis. The cut surface shows yellow, pink-tan, or whitish nodules separated by fibrous bands. Microscopically, the nodularity is quite clearly evident and best appreciated at low magnification. Broad concentric bands of birefringent collagen surround well-defined cellular nodules which often have a mottled or moth-eaten appearance due to clusters of lacunar cells, microabscesses, or areas of necrosis (see next 5 images).

    Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission.

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