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Recurrent Hodgkin Lymphoma

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Recurrent Hodgkin Lymphoma: When classic Hodgkin lymphoma (cHL) relapses, it usually retains the morphologic and immunophenotypic features of the primary tumor. However, in some cases, radiation and chemotherapy may induce changes, including greater number of pleomorphic tumor cells or lymphocyte-depleted morphology.

The histologic subtype in relapsed disease should be assigned based on the pre-treatment biopsies. The possibility of secondary neoplasm should be ruled out if the morphologic criteria don't fit cHL. Immunochemistry should be performed to confirm the characteristic immunophenotype of HRS cells before the diagnosis of relapsed cHL is made.

The image shows recurrent nodular sclerosis classic Hodgkin lymphoma . Numerous classic bi- or multinucleated Reed-Sternberg cells with prominent nucleoli are present in a mixed background infiltrate of lymphocytes, plasma cells, neutrophils, eosinophils, and histiocytes.

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