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Flow-sorting and Exome Sequencing of the Reed-Sternberg Cells of Classical Hodgkin Lymphoma
Published on: June 10, 2017
The Pathology of Hodgkin's Disease: What's New?
1James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Insights
Pathologists face challenges in diagnosing Hodgkin's disease (HD), identifying prognostic factors, and defining the neoplastic cell. Recent studies reveal Reed-Sternberg cells in HD are often of lymphoid origin, blurring lines with non-Hodgkin's lymphoma.
Area of Science:
- Pathology
- Hematology
- Oncology
Background:
- Hodgkin's disease (HD) diagnosis involves correct identification, prognostic factors, and neoplastic cell origin.
- The origin of Reed-Sternberg cells and HD pathogenesis remain areas of investigation.
- Distinguishing HD from non-Hodgkin's lymphoma can be challenging.
Purpose of the Study:
- To review the diagnostic challenges in Hodgkin's disease from a pathologist's perspective.
- To discuss the identity and origin of the neoplastic cell in Hodgkin's disease.
- To evaluate the role of immunophenotype and genotype in understanding Hodgkin's disease.
Main Methods:
- Review of diagnostic criteria for Hodgkin's disease.
- Analysis of immunophenotypic and genotypic data of Reed-Sternberg cells.
- Comparison of Hodgkin's disease with non-Hodgkin's lymphoma.
Main Results:
- Reed-Sternberg cells in many Hodgkin's disease cases are of lymphoid origin.
- The distinction between Hodgkin's disease and non-Hodgkin's lymphoma is less clear than previously thought.
- Despite overlap, fundamental differences persist in clinical, histological, immunophenotypic, and genotypic features.
Conclusions:
- Accurate diagnosis of Hodgkin's disease remains crucial.
- Understanding the lymphoid origin of Reed-Sternberg cells refines diagnostic approaches.
- While diagnostic challenges exist, key distinctions between Hodgkin's disease and non-Hodgkin's lymphoma are maintained.
Abstract:
From the viewpoint of the pathologist, there are three major issues concerning Hodgkin's disease (HD) that must be addressed. First is making the correct diagnosis; second is identifying any pathological features that may be of prognostic importance; and third is defining the identity of the neoplastic cell. Since Hodgkin's disease (HD) was first described, the origin of the Reed-Sternberg cell and the pathogenesis of HD have remained elusive. Recently developed techniques have allowed investigators to analyze the immunophenotype and genotype of Reed-Sternberg cells. The results of these studies include recognition that, in many cases, Reed-Sternberg cells are of lymphoid origin. Thus, although in most cases of HD the diagnosis is straightforward on routinely stained sections, the conceptual dividing line between HD and non-Hodgkin's lymphoma is not as sharp as it once seemed. Occasionally, there is difficulty in distinguishing between HD and non-Hodgkin's lymphoma. Nevertheless, fundamental differences in the clinical features, histology, immunophenotype, and genotype between non-Hodgkin's lymphoma and HD remain. The impact of histological features on prognosis are controversial, largely because of the excellent prognosis of most cases of HD.
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