A patient presented with fever, night sweats and weight loss. Clinical examination revealed painless lymphadenopathy. Microscopy shows these cells. Most likely condition is:
B. Chronic lymphocytic leukemia
C. Hodgkin’s lymphoma
D. Secondary TB
These cells are Reed Sternberg cells
Ans: C i.e. Hodgkins lymphoma
Reed–Sternberg cells (also known as lacunar histiocytes )
- These are different giant cells found with light microscopy in biopsies from individuals with Hodgkin’s lymphoma
- They are usually derived from B lymphocytes, classically considered crippled germinal center B cells, meaning they have not undergone hypermutation to express their antibody. Seen against a sea of B cells, they give the tissue a moth-eaten appearance.
- Classification of Hodgkin’s is based on the reactive cell mixture. Immunomarkers are used (e.g., CD15 and CD30).
- Reed–Sternberg cells are large 30–50 microns and are either multinucleated or have a bilobed nucleus with prominent eosinophilic inclusion-like nucleoli (thus resembling an “owl’s eye” appearance).
- Reed–Sternberg cells are CD30 and CD15 positive, usually negative for CD20 and CD45.
- The presence of these cells is necessary in the diagnosis of Hodgkin’s lymphoma – the absence of Reed–Sternberg cells has very high negative predictive value.
- They can also be found in reactive lymphadenopathy (such as infectious mononucleosis immunoblasts which are RS like in appearance, carbamazepine associated lymphadenopathy) and very rarely in other types of non-Hodgkin lymphomas. Anaplastic large cell lymphoma may show RS like cells also.