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Childhood Malignancies, Cysts, and Sinuses of the Head and Neck
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Reed-Sternberg cells (large, multinucleated cells with abundant cytoplasm) are diagnostic. Can involve lower cervical, supraclavicular, and mediastinal nodes. Some subtypes are associated with Epstein-Barr virus.
Paper 4
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Non-Hodgkin’s lymphoma is a group of lymphomas which are predominantly B-cell proliferations. It typically presents in adults with lymphadenopathy. Fever, weight loss, lethargy and night sweats may also be present. Investigations may show pancytopenia and a mediastinal mass on CXR. Node biopsy is essential and staging may require CT or MRI scanning. Reed-Sternberg cells are present in Hodgkin’s lymphoma. Histologically low-grade lymphomas are slow growing but often incurable and the high-grade lymphomas are more aggressive but curable with chemotherapy regimes.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Reed–Sternberg cells are diagnostic for Hodgkin’s lymphoma. The Philadelphia chromosome and decreased quantities of leucocytes alkaline phosphatase are commonly observed in chronic myelogenous leukaemia. Auer rods are most often seen in increased numbers in acute myelogenous or myelomonocytic leukaemia. Pappenheimer bodies are abnormal iron granules found inside red blood cells. They are associated with sideroblastic anaemia, haemolytic anaemia, and sickle cell disease.
Infectious mononucleosis-related tonsillar hyperplasia mimicking T-cell lymphoma on histopathology: A rare case and review
Published in Acta Oto-Laryngologica Case Reports, 2020
Usman Asad, Irfan Warraich, Winslo Idicula
Pleomorphic binucleated cells resembling Reed-Sternberg cells, as well as single atypical cells seen in some Hodgkin and T-cell lymphomas, were observed (Figure 2(B)). Mitotic figures were numerous. However, only scattered cells were seen staining for both CD15 and CD30, making the diagnosis of a classical Hodgkin lymphoma unlikely. The CD30 negativity argued against the case of anaplastic large cell lymphoma (a peripheral T cell lymphoma). ALK-1 was also negative. This combination of minimal CD30 staining and negative ALK-1 staining made the diagnosis of anaplastic large cell lymphoma unlikely. An EBV-encoded RNA in-situ hybridization (EBER ISH) was strongly and diffusely positive in large EBV-infected cells (Figure 2(F)). Therefore, the diagnosis of infectious mononucleosis-related tonsillar hyperplasia was made rather than lymphoma.
Cranio-spinal Rosai Dorfman disease: case series and literature review
Published in British Journal of Neurosurgery, 2019
Shashank S. Joshi, Shilpa Joshi, Girish Muzumdar, Keki E. Turel, Rajan M. Shah, Indoo Ammbulkar, Muhammad Masood Hussain, Kishor A. Choudhari
Immunohistochemistry-The characteristic RDD histiocytes are strongly positive for S-100 protein (Figure 4(B)) and CD 68 and negative for CD 1a.45,46 Staining for CD 20 and CD 3 show mixed populations of B and T lymphocytes in the background. Kappa and lambda light chain immunohistochemistry show polytypic staining in the plasma cell infiltrates. The stain for epithelial membrane antigen (EMA) decorates plasma cells and meningeal cells. Immunohistochemistry finding in various conditions which can mimic cranial RDD are summarised in Table 3.47 Intracranial Hodgkin’s disease is rare and is typically associated with relapse.48 Classic Reed Sternberg cells can readily distinguish them from RDD histiocytes. Classic Reed Sternberg cells and variants, lack emperipolesis and S-100 immunoreactivity and are typically positive for CD 15 and CD 30.49 Intracranial affection by plasmacytoma is relatively rare but similar to the case of intracranial RDD, these lesions are dural-based. This diagnosis is easily excluded by demonstrating plasma cell infiltrates of plasmacytoma are monoclonal whilst RDD are polyclonal.50,51 Plasma cell granuloma is a discrete, inflammatory mass lesion attached to dura and associated with fibrosis.52–55 Many lesions previously reported as intracranial plasma cell granulomas or inflammatory pseudotumours are in fact RDD.56–58 The various differential diagnoses for craniospinal RDD are summarised in Table 3 and include meningioma, lymphoma, plasmacytoma and chordoma.
Multifocal vertebral sclerosing bone changes and soft tissue masses caused by Hodgkin’s lymphoma in a patient with systemic lupus erythematosus: a case report
Published in Scandinavian Journal of Rheumatology, 2019
S Krabbe, J Helweg-Larsen, A Loft, S Jacobsen
After these unsuccessful treatments, the vertebral biopsies were reviewed. This time, a few, scattered, large cells, some with double nuclei and eosinophilic nucleoles, reminiscent of Hodgkin cells, but not classic Reed–Sternberg cells, were observed in a tissue sample taken from Th4. By immunohistochemical staining, the cells were positive for CD30, epithelial membrane antigen, Epstein–Barr virus, and paired box-5. Based on this, a diagnosis of Hodgkin’s lymphoma was finally made. Treatment with escalated-dose BEACOPP chemotherapy (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) led to remission of Hodgkin’s lymphoma with no progression of the sclerosing bone changes at follow-up after 3 years. The patient’s sensory and motor deficiencies are unchanged.