STORY: 19 yrs male with neck/axillary and mediastinum lymphadenopathy and fever with night sweats, hepatomegaly, ascites. Lymph node blocks (axilar) was sent for second opinion with diagnosis of Hodkin's lymphoma. Bone marrow biopsy: NEGATIVE.  
 
HISTO: Solid diffuse sheets of medium large cells with scattered multinucleated or lobated giant cells ("DLBCL or ALCL like pattern") with purelly CHL immunophenotype: EBER(-); CD30+ > CD15+; LCA(-); Fascin+; CD21(+/-); Mum1+; CD3/CD2/CD5+ (focal abberant); ALK1(-); BOB1/Oct2(-); Pax5+ (weak); CD20/CD79a/Ig kappa/lambda/CD138(-); Bcl6/CD10/CyclinD1(-); EBV LMP1(-); EMA(-); CD4/CD7/CD8/GranzymB(-). Necrosis up to 30%.  
MOLECS: B clone: IGH locci FR1, FR2 and D-J.  
 
Follow up: escBEACOPP scheme applied. Lymphadenopathy was reduced up to 30%, no fever, organomegalies or other complications are absent too. No trasfussions at the moment.  
 
 
PROPOSAL: Still classic Hodgkin's lymphoma, but: SINCYTIAL NS2 or just LYMPHOCYTE depleted (I'm very sceptic about that...). Some T Ag expression as worse prognostic sign?