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Hodgkins Disease - lymphocyte predominant
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Hodgkins Disease - lymphocyte predominant

A medium power view of a lymphocyte predominant Hodgkins disease shows the two characteristic features of this disease.
Towards the center of this image is a large cell with abundant cytoplasm and two nuclei.
Notice that these two nuclei have a vesicular chromatin pattern, with a dark staining rim of chromatin and a large paler interior.
The two large, deep staining structures at the centers of these two nuclei are the nucleoli.
Almost every other cell in this field is a small lymphocyte.
To the right of the Reed-Sternberg cell at the center of this image is a lymphocyte that appears to be undergoing mitotic division.
(Description By:T.V.Rajan, M.D. )
(Image Contrib. by:T.V.Rajan, M.D. UCHC )
Hodgkin's Disease, Lymphocyte Predominant Type
Etiology

Unknown
Pathogenesis

Very small population of neoplastic cells of L(ymphocyte) and H(istiocytic) subtype
Marked inflammatory reaction driven by cytokines secreted by neoplastic cells including IL 5 (attracting eosinophils), IL4, tumor necrosis factor alpha, GM-CSF,
Epidemiology

0.7% of all new cancers in the U.S. overall for Hodgkin's Disease
Predominantly male and under 35
Usually cervical lymph nodes
Relatively rare subtype
General Gross Description

Large fleshy tan node which may show ill defined nodularity
General Microscopic Description

Usually composed of small lymphoctyes, although histiocytes may be seen and may predominate (correct term is lymphocytic and/or histiocytic subtype
Difficult to find diagnostic binucleate Reed-Sternberg cells with eosinophilic macronucleoli ("owl eye" nuclei)
Polypoid mononuclear Reed-Sternberg variant with complex nuclear outline, chromatin clearing, and inconspicous nucleoli
Aberrant mitoses (ring shaped)
Mummified cells
Malignant cells demonstrate B cell markers including CD45+, CD30-, CD15-
Clinical Correlation

Tend to be confined to cervical lymph node(s) but may spread continguously
Carries an excellent prognosis
References

Jaffe ES, Surgical Pathology of the Lymph Nodes and related organs, 2nd edition, Philadelphia, W.B. Saunders, 1995, pp.141-151.
Hodgkin's Disease, Lymphocyte Predominant Type
Synopsis by: Melinda Sanders M.D. (T08000M96513)[320]
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