What are Reed-Sternberg Cells?
Reed-Sternberg cells are distinctive, large, abnormal cells typically found in patients diagnosed with
Hodgkin lymphoma. These cells are crucial for the histological diagnosis of this type of lymphoma. Named after the pathologists Dorothy Reed and Carl Sternberg, who first described them, Reed-Sternberg cells are generally multinucleated or have a bilobed nucleus with prominent nucleoli, giving them an "owl's eye" appearance.
Histological Characteristics
Reed-Sternberg cells are characterized by their large size (often 15-45 micrometers in diameter) and distinctive morphology. They usually contain multiple nuclei or a single nucleus with multiple lobes. The nuclei are surrounded by a clear zone, and the nucleoli are prominent and eosinophilic. The cytoplasm is abundant and amphophilic. These characteristics make them easily identifiable under a microscope when stained with
H&E (Hematoxylin and Eosin).
Immunohistochemical Markers
To confirm the presence of Reed-Sternberg cells, immunohistochemical staining is often employed. These cells typically express CD15 and CD30 markers, which can help differentiate them from other types of lymphoid cells. They are usually negative for CD45, a common leukocyte marker, which further aids in their identification.Role in Hodgkin Lymphoma
The presence of Reed-Sternberg cells is a hallmark of Hodgkin lymphoma, a type of lymphatic cancer. Their identification is essential for the diagnosis and classification of this disease. Reed-Sternberg cells are thought to originate from B lymphocytes, but they undergo a transformation that makes them lose the normal characteristics of these cells. Their presence triggers an inflammatory response, leading to the formation of the tumor mass.Histopathological Examination
During the histopathological examination, a biopsy of the affected lymph node is taken. The tissue is then fixed, sectioned, and stained for microscopic analysis. Pathologists look for the distinctive features of Reed-Sternberg cells to make a diagnosis. The surrounding inflammatory background, consisting of a mixture of eosinophils, plasma cells, and reactive lymphocytes, also provides clues to the presence of Hodgkin lymphoma.Clinical Significance
The detection of Reed-Sternberg cells has significant clinical implications. Their presence confirms a diagnosis of Hodgkin lymphoma, which requires specific treatment protocols, including chemotherapy and radiation therapy. The prognosis and treatment plan can vary depending on the subtype of Hodgkin lymphoma, which is classified based on the histological appearance and the microenvironment surrounding the Reed-Sternberg cells.Challenges in Diagnosis
Despite their distinctive features, identifying Reed-Sternberg cells can sometimes be challenging. They may be present in small numbers or may be masked by the surrounding inflammatory cells. In such cases, additional immunohistochemical stains and molecular techniques may be necessary to accurately identify these cells and confirm the diagnosis.Conclusion
Reed-Sternberg cells play a crucial role in the histological diagnosis of Hodgkin lymphoma. Their distinctive morphology, coupled with immunohistochemical markers, makes them identifiable under a microscope. Understanding their characteristics and implications is essential for pathologists in diagnosing and classifying Hodgkin lymphoma, ultimately guiding appropriate clinical management.
