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Zorluk: KolayPathology and Biopsy Interpretation

A 24-year-old male college student undergoes an excisional lymph node biopsy for a painless, progressively enlarging cervical mass accompanied by night sweats and unexplained fever. The pathology report describes an effaced nodal architecture with a mixed inflammatory background composed of small lymphocytes, eosinophils, and macrophages. Scattered throughout this background are large, atypical, binucleated cells with prominent, eosinophilic nucleoli resembling owl eyes. Based on this histopathologic description, which of the following immunohistochemical markers are typically positive in these atypical neoplastic cells? (Select all that apply)

  1. CD15Cevap
  2. B
    CD20
  3. CD30Cevap
  4. D
    CD3
  5. E
    Cytokeratin AE1/AE3

Cevap

The atypical cells will typically be positive for CD15 and CD30.
The clinical vignette and histopathology describing large, binucleated cells with prominent eosinophilic nucleoli ('owl-eye' appearance) in a mixed inflammatory background are classic for Reed-Sternberg cells. This establishes the diagnosis of classic Hodgkin lymphoma. The pathognomonic immunohistochemical profile for classic Reed-Sternberg cells is positive expression of CD15 and CD30.

Adım Adım Çözüm

1
Analyze the clinical and histopathologic findings.
A young adult with B symptoms and a cervical node showing large, binucleated cells with prominent eosinophilic nucleoli ('owl-eye' appearance) in an inflammatory background.
Identifying the classic morphologic description establishes the primary diagnosis.
2
Correlate the morphology with a specific diagnosis.
The described cells are Reed-Sternberg cells, which are pathognomonic for classic Hodgkin lymphoma.
Biopsy interpretation requires matching cellular morphology to the disease entity.
3
Determine the expected immunohistochemical profile for the diagnosed entity.
Classic Reed-Sternberg cells characteristically express CD15 and CD30, while lacking CD20 and CD45.
Confirming the diagnosis of classic Hodgkin lymphoma relies on this specific immunophenotype.

Anahtar Kavram

Immunohistochemical profile of classic Hodgkin lymphoma
Tahmini Süre:45s
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Pathology and Biopsy Interpretation

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