Overview of Reed-Sternberg Cell
The
Reed-Sternberg cell is a distinctive type of giant cell found in
Hodgkin lymphoma. These cells are crucial for the histopathological diagnosis of the disease. Reed-Sternberg cells are typically large, with a diameter of 20-50 micrometers, and have a characteristic appearance that includes a bi-lobed nucleus and prominent nucleoli.
Histological Characteristics
In histological sections, Reed-Sternberg cells can be identified by their large size, binucleated or multinucleated structure, and the presence of prominent eosinophilic nucleoli. The nuclei often have a "mirror image" appearance. The cytoplasm of these cells is abundant and slightly basophilic. Reed-Sternberg cells are usually found in an inflammatory background consisting of lymphocytes, eosinophils, and plasma cells.Immunohistochemical Markers
Reed-Sternberg cells can be identified using
immunohistochemistry. They typically express the following markers:
- CD15
- CD30
- PAX5 (weakly positive)
These markers help differentiate Reed-Sternberg cells from other large cells found in lymphoid tissues.
Clinical Significance
The presence of Reed-Sternberg cells is a hallmark of Hodgkin lymphoma, and their identification is critical for diagnosis. Hodgkin lymphoma can be divided into classical Hodgkin lymphoma, which is characterized by the presence of Reed-Sternberg cells, and nodular lymphocyte-predominant Hodgkin lymphoma, which lacks these cells.Origin and Pathogenesis
The exact origin of Reed-Sternberg cells is believed to be from B lymphocytes, although they have lost many of the typical B-cell markers. Genetic studies have shown that these cells often have rearrangements of the immunoglobulin genes, suggesting a B-cell lineage.Microscopic Appearance
Under the microscope, Reed-Sternberg cells exhibit a distinctive "owl's eye" appearance due to their prominent nucleoli. The nuclei are often bi-lobed, giving them a mirror-image appearance. These cells stand out in histological sections due to their large size and unique nuclear features.Diagnostic Challenges
One of the challenges in diagnosing Hodgkin lymphoma is that Reed-Sternberg cells can be rare and difficult to identify in small biopsy samples. In addition, other conditions can sometimes mimic the appearance of Reed-Sternberg cells, such as infectious mononucleosis and certain types of non-Hodgkin lymphoma.Conclusion
Reed-Sternberg cells are a key diagnostic feature of Hodgkin lymphoma. Their identification through histological examination and immunohistochemical staining is essential for accurate diagnosis and subsequent treatment planning. Understanding their characteristics, origin, and clinical significance provides valuable insights into the pathology of Hodgkin lymphoma.
