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Pathology of Hodgkin Lymphoma

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Book cover Precision Molecular Pathology of Hodgkin Lymphoma

Part of the book series: Molecular Pathology Library ((MPLB))

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Abstract

The primary objective of this chapter is to describe the histopathologic features of Hodgkin lymphoma and its many variants. Hodgkin lymphoma is a lymph node-based neoplasm derived in nearly all cases from clonal genetically unstable germinal center B lymphocytes. There are two highly distinct types of Hodgkin lymphoma that differ in clinical features, pathobiology, and histopathology. The clonal cells in the more common classical form of Hodgkin lymphoma termed classical Reed-Sternberg cells are large cells with multinucleated or multilobulated nuclei, prominent nucleoli, and a unique immunophenotype that belies their B cell origin. The histopathologic diagnosis of classical Hodgkin lymphoma relies on morphologic and immunohistochemical detection of classical Reed-Sternberg cells within a reactive inflammatory infiltrate composed of variable numbers of small lymphocytes, granulocytes, and macrophages, with variable degrees of fibrosis. In contrast, while the clonal cells of nodular lymphocyte predominant Hodgkin lymphoma, termed LP cells, are also B cell derived, their morphologic and immunophenotypic features differ markedly from that of classical Reed-Sternberg cells. LP cells are typically medium-sized mononuclear cells with irregular lobulated nuclei that, in contrast to classical Reed-Sternberg cells, express a B cell immunophenotype. Also, in contrast to classical Hodgkin lymphoma, the reactive infiltrate in most cases of nodular lymphocyte predominant Hodgkin lymphoma consists of mantle zone B cells and CD4 T cells without granulocytes and fibrosis. The histopathology of entities that are related to or may mimic Hodgkin lymphoma, including Castleman disease, progressive transformation of germinal centers, and mediastinal gray zone lymphoma, is briefly discussed.

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Abbreviations

ALCL:

Anaplastic large cell lymphoma

CHL:

Classical Hodgkin lymphoma

cRSC:

Classical RS cell

EBER:

Epstein-Barr early RNA

EBV:

Epstein-Barr virus

HL:

Hodgkin lymphoma

IGF:

Insulin-like growth factor

IHC:

Immunohistochemistry

ISH:

In situ hybridization

LDHL:

Lymphocyte-depleted Hodgkin lymphoma

LMP:

Latent membrane protein

LP:

Lymphocyte predominant

LRHL:

Lymphocyte-rich Hodgkin lymphoma

MCHL:

Mixed cellularity Hodgkin lymphoma

NHL:

Non-Hodgkin lymphoma

NLPHL:

Nodular lymphocyte predominant Hodgkin lymphoma

NSHL:

Nodular sclerosis Hodgkin lymphoma

PTGC:

Progressive transformation of germinal centers

RS:

Reed-Sternberg

RSC:

Reed-Sternberg cell

TCHRLBCL:

T cell/histiocyte-rich large B cell lymphoma

Tfh:

Follicular T helper cell

TGFβ:

Tumor-derived growth factor beta

Treg:

Regulatory (suppressor) T cells

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  1. Pathology and Laboratory Medicine, Yale University School of Medicine, New Haven, CT, 06525, USA

    S. David Hudnall M.D.

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  1. Department of Pathology and Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA

    S. David Hudnall

  2. Universität Duisburg-Essen, Institute for Cell Biology, Essen, Nordrhein-Westfalen, Germany

    Ralf Küppers

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Hudnall, S.D. (2018). Pathology of Hodgkin Lymphoma. In: Hudnall, S., Küppers, R. (eds) Precision Molecular Pathology of Hodgkin Lymphoma . Molecular Pathology Library. Springer, Cham. https://doi.org/10.1007/978-3-319-68094-1_2

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