Case History
22-year-old female with hilar and mediastinal lymphadenopathy, FNA of mediastinal lymph node.
What stains would you order to further work up the case?
B. CD15, CD30
C. CK7, CK20
D. Gata-3, Mammaglobin
The correct answer is B. CD15, CD30
Discussion:
The diff quik stain shows a polymorphous lymphoid background with predominately small mature appearing lymphocytes, occasional histiocytes and rare large atypical lymphoid cells (Reed-Sternberg cells), morphologically compatible with Classic Hodgkin’s lymphoma. Reed-Sternberg cells show strong nuclear staining for CD15, strong cytoplasmic staining for CD30, and dim nuclear staining for Pax-5. Classic Hodgkin’s lymphoma can be sub classified into nodular sclerosing, lymphocyte rich, lymphocyte depleted, and mixed cellularity based on the non-neoplastic background cells and stroma. Classic Hodgkin’s lymphoma has a bimodal age distribution with peaks at 15-35 years old, and a second peak around 50-70 years of age. With current stage adapted therapy there is an 80-90% cure rate.