Hodgkin's Lymphoma Pathology

By Dr Ananya Mandal, MD

Hodgkin’s lymphoma is a rare cancer of the lymphatic system that affects groups of lymph nodes, such as those found in the neck, armpits or groin.

In particular, the B-lymphocytes multiply at an abnormal rate and accumulate in the lymph nodes. Diagnosis is based on microscopic examination of a lymph node biopsy.

Symptoms and macroscopic appearance

The most common symptom of this condition is swelling in the areas of the body where lymph nodes are present. More general symptoms include fever, weigh loss, night sweats, fatigue, coughing and itchy skin.

The laterocervial lymph nodes in the side of the neck are often enlarged, although their shape is usually preserved since the cancer does not invade the outer capsule of the lymph nodes. When the surface of an affected lymph node is cut open, the tissue is a white-grey colour and uniform. In the nodular sclerosis subtype, a nodular aspect may be present.

Microscopic appearance

On microscopic examination, the architecture of the lymph node may be partially or completely scattered by the presence of cancerous cells (referred to as Reed-Sternberg cells) amongst a background of reactive lymphocytes, plasmocytes, eosinophils and histiocytes.

The Reed-Sternberg cells are typically about 20 to 50 μm in size with a finely granular and homogenous cytoplasm, a thick nuclear membrane and an eosinophilic nucleus. In around half of cases, these Reed-Sternberg cells are infected with Epstein-Barr virus.

Reviewed by , BSc

Further Reading

Last Updated: Aug 19, 2014

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