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Nodular Sclerosis Hodgkin Lymphoma

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Lacunar cells are the predominant variant of Reed-Sternberg (RS) cell seen in nodular sclerosis subtype of classic Hodgkin lymphoma. Classic RS cells are rare or absent.

The characteristic feature of lacunar cells is lacuna-like spaces around the nucleus due to shrinkage artifact in formalin-fixed tissues. The cytoplasm is condensed in the perinuclear region leaving empty space around it with spider web-like extensions to the cytoplasmic borders. The nucleus is multilobated with coarse chromatin. The nucleoli are smaller than those seen in classic RS cells.

Lacunar cells may be scattered singly throughout the lymph node or arranged in compact clusters or diffuse sheets (especially in grade II nodular sclerosis).

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