Mixed Cellularity Hodgkin Lymphoma
Mixed cellularity classic Hodgkin lymphoma (cHL): There is lymph node enlargement with diffuse effacement of the nodal architecture. In the early stages, the tumor growth is mainly interfollicular with scattered residual, atrophic germinal centers. The mottled appearance in this low magnification view is due to aggregates of epithelioid histiocytes throughout the lymph node. Such cases have been termed histiocyte-rich mixed cellularity cHL and must be distinguished from other histiocyte-rich forms of non-Hodgkin lymphomas, histiocyte storage disorders, and granulomatous inflammatory conditions. A typical case of mixed cellularity cHL consists of diagnostic Hodgkin and Reed-Sternberg (HRS) cells in a polymorphous reactive infiltrate with B- and T-cells, neutrophils, eosinophils, macrophages, plasma cells, and mast cells. There is no sclerosis.