Which cell type is pathognomonic for classical Hodgkin lymphoma?

Question

Accepted Answer

C. Reed-Sternberg cells. ## Pathognomonic Cell of Classical Hodgkin Lymphoma

**Key Point:** Reed-Sternberg (RS) cells are the diagnostic hallmark of classical Hodgkin lymphoma (cHL). They are large, multinucleated or multilobated cells with prominent eosinophilic nucleoli ("owl's eye" appearance).

### Morphologic Features of RS Cells

| Feature | Description |
| --- | --- |
| **Size** | 20–50 μm or larger |
| **Nuclei** | Multiple (≥2), often 10+ |
| **Nucleoli** | Prominent, eosinophilic, resembling owl's eyes |
| **Cytoplasm** | Abundant, basophilic |
| **Membrane** | Thick, well-defined |

### Related Cell Types

- **Hodgkin cells:** Mononuclear variants of RS cells; also diagnostic but less specific.
- **Lacunar cells:** RS cells in formalin-fixed tissue that appear to sit in empty spaces ("lacunae") due to retraction artifact.
- **Mummified cells:** Apoptotic/degenerating RS cells; not diagnostic on their own.

**High-Yield:** RS cells are CD30^+^, CD15^+^, and typically CD45^−^, CD20^−^ (weak or absent), and EBV^+^ (in some cases, especially mixed cellularity subtype).

**Clinical Pearl:** The presence of even a few RS cells in a background of small lymphocytes, eosinophils, and histiocytes is sufficient for diagnosis of cHL, provided the morphology and immunophenotype are consistent.

Answer

A. Lacunar cells

Answer

B. Mummified cells

Answer

D. Hodgkin cells

Which cell type is pathognomonic for classical Hodgkin lymphoma?

Explanation

Pathognomonic Cell of Classical Hodgkin Lymphoma

Morphologic Features of RS Cells

Related Cell Types

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Feature	Description
Size	20–50 μm or larger
Nuclei	Multiple (≥2), often 10+
Nucleoli	Prominent, eosinophilic, resembling owl's eyes
Cytoplasm	Abundant, basophilic
Membrane	Thick, well-defined