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Classic Hodgkins Lymphoma, EBV+, hemophagocytosis (6746) » HE 7.jpg
Filename: HE 7.jpg
[Classic Hodgkins Lymphoma, EBV+, hemophagocytosis]
HISTORY: 41 yrs old male presents with B symptoms and hepatosplenomegaly only (CT not reveal any lymphadenopathy). Single subclavicular node was hardly found and biopsied as well as threpine was made.  
Blood: cytopenia (BM obliterated). BM: hemophagocytosis (original smear in the hospital) and giant cells.  
NODE: Classic RS and H cells in moderate cellular histiocytic background with multiple cytotox CD8+ cells with marked nuclear irregularities.  
BM: 80% of the population- diffuse involvement of the same tumor.  
IH NODE: Giant cells (cHL): CD30+; CD15+; CD20+/-; LCA+/-; EMA-; EBV LMP1+; Pax5+; CD79a/CD43(-).  
IH BM: Giant cells: CD30+; CD15+; CD20+; EBV LMP1+; CD79a-/+ (scattered); cyclinD1+.  
INFILTRATE: CD68+CD4+ Ma reach; CD3/CD8/Perforin/TIA1/GranB+ >> CD20+ lymphos with marked nuclear abnormalities of cytotox T cells.  
T population: CD3+ 100%; CD7/CD5/CD2+ 70%; CD8+ >> CD4+.  
PCR: gama/beta polyclonal background with possible "small" clone. B clonality in progress (laser microdissection technique is implemented).  
VIRTUAL SLIDES:  
HE: http://193.219.87.170:82/imageserver/LT_TELEPATHOLOGY/Ugnius/Studentams/B08-36490_Hodzkino_limfoma_misriu_lasteliu_variantas.svs/view.apml?  
 
BM: http://193.219.87.170:82/imageserver/LT_TELEPATHOLOGY/Ugnius/Studentams/B08-36486_Hodzkino_limfoma_misriu_lasteliu_variantas.svs/view.apml?  
 
PROPOSAL: cHL: MC (enreached in macrophages and cutotox T cells).  
QUESTION: 1. Nuclear irregularities in CD8+ CD3+ cytotoxic T population and diffuse (not focal as usual) involvement of bone marrow. 2. Some giant cells in lymph node seems to be LCA+ (majority) and in BM CD79a+ (focal, minority)
Sender: ugnius
2009-01-15 11:17
INCTR - EBMWG Hematopathology Online

Last modified: 2009-01-15 11:17:42