61 yrs male underwent lymph node biopsy due to neck lymphadenopathy, weight loss and fever.  
Clinical diagnosis: HL.  
HISTO: On the slides: focal septation and "granulomatous" necrosis with sincytial growth, focal sinus spread, focal L and H picture.  
IH: GIANT CELLS: CD30+ 100%; CD15+ 15%; EMA+ 60%; GranzymB/Perforin+ 80%, TIA1+ 60%; CD4+ 80%; LCA-/+?; ALK1(-), Bcl6(+/-) 40% (weak), CD43+ 20%, CyclinD1/CD20/CD3/CD79a/CD2/CD5/CD7(-), EBV LMP1(-), Pax5-.  
 
PROPOSED DIAGNOSIS: cHL (MC?) with cytotoxic phenotype and ALCL like (sinus) spread.  
QUEST: 1. Septation and nodularity: NS grade II possibility? 2. CD4+ cytotox + phenotype?  
 
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