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| Hodgkin's Disease, Nodular Sclerosing Type |
| Etiology • Unknown |
| Pathogenesis • Relatively small population of neoplastic cells which include classic Reed Sternberg cell as well as mononuclear variant, lacunar cells • Marked inflammatory reaction driven by cytokines secreted by neoplastic cells including IL 5 (attracting eosinophils), IL4, tumor necrosis factor alpha, GM-CSF • TNF beta associated with fibrosis, |
| Epidemiology • 0.7% of all new cancers in the U.S. overall for Hodgkin's disease • Average age 32 years • Only variant more common in women • Often presents in mediastinum • One of most common varieties |
| General Gross Description • Enlarged, firm, fleshy lymph node with irregular nodules separated by bands of firmer, fibrotic tissue |
| General Microscopic Description • Sclerosis, in broad bands of birefringent collagen • Lacunar cells with nuclei containing lacy chromatin, small to medium sized nucleoli, and polylobation; cytoplasm may be clear or palely eosinophilic • Pale areas around cells on formalin fixation • Mark with CD30 (Ki-1) and CD15 (Leu M-1); do not mark with CD45 (LCA) • Reed Sternberg cells are classic binucleate cells with prominent macronucleoli which are eosinophilic (owl eye) |
| Clinical Correlation • Spreads sequentially along nodal groups • Responsive to locoregional treatment with radiation • Excellent prognosis |
| References • Jaffe ES, Surgical Pathology of the Lymph Nodes and related organs, 2nd edition. Philadelphia, W.B. Saunders, 1995, pp.151-166. |
| Hodgkin's Disease, Nodular Sclerosing Type |
| Synopsis by: Melinda Sanders M.D. (T08000M96563)[319] |
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