The Hodgkin’s disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin’s disease were correct, which of the following cells would the pathologist expect to find?
A. Reed-Sternberg cells.
B. Lymphoblastic cells.
C. Gaucher’s cells.
D. Rieder’s cells
Correct Answer: A. Reed-Sternberg cells
A definitive diagnosis of Hodgkin’s disease is made if Reed-Sternberg cells are found on pathologic examination of the excised lymph node. Four features characterize Hodgkin lymphomas. They commonly arise in the cervical lymph nodes; the disease is more common in young adults; there are scattered large mononuclear Hodgkin and multinucleated cells (Reed-Sternberg) intermixed in a background of a mixture of non-neoplastic inflammatory cells; finally, T lymphocytes are often observed surrounding the characteristic neoplastic cells.
Option B: Lymphoblasts are immature cells found in the bone marrow of patients with acute lymphoblastic leukemia. Lymphoblast is an immature white blood cell that gives rise to a type of immune cell known as a lymphocyte. The nucleus contains moderately fine chromatin (readily stainable nuclear material) and has a well-defined nuclear membrane. There are one or two nucleoli, and the cytoplasm is small or moderate in amount. Lymphoblasts that grow and divide uncontrollably cause a type of cancer known as acute lymphoblastic leukemia.
Option C: Gaucher’s cells are large storage cells found in patients with Gaucher’s disease. The Gaucher cell results from the accumulation of excessive glucocerebroside in cells of the monocyte-macrophage system. It is characterized ultrastructurally by the presence of cytoplasmic inclusions which consist of tubule-like structures measuring 130 to 150 Ao in diameter.
Option D: Rieder’s cells are myeloblasts found in patients with acute myelogenous leukemia. They are abnormal myeloblasts in which the nucleus may be widely or deeply indented or may actually be a bilobate or multilobate structure; frequently observed in acute leukemia.