Mediastinum
Hematological neoplasms / lesions
Hodgkin lymphoma

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 21 June 2018, last major update December 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Hodgkin lymphoma[TI] mediastinum

Cite this page: Gulwani, H. Hodgkin lymphoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mediastinumhodgkinslymphoma.html. Accessed July 19th, 2018.
Definition / general
  • Most common mediastinal malignant tumor
  • Systemic symptoms (fever, weight loss, night sweats, fatigue) are common
  • 90% curable at stages I - II
Epidemiology
  • Usually young women in 20s and 30s
Sites
  • Often involves thymus, mediastinal nodes or both; involves adjacent structures by direct extension
Diagrams / tables

Images hosted on other servers:

Hodgkin lymphoma classification schemes

Clinical features
  • Derived from B cells, associated with EBV and defective cytokinesis (J Clin Pathol 2002;55:162)
  • Follicular variant: subtype of classic Hodgkin lymphoma which resembles nodular lymphocyte predominant Hodgkin lymphoma (Am J Clin Pathol 2002;117:29)
  • Syncytial variant: resembles nodular sclerosis but with confluent sheets of Reed-Sternberg and variant cells
Gross description
  • May produce multilocular thymic cysts
Microscopic (histologic) description
  • Prominent cysts at low power
  • Extensive fibrosis
Microscopic (histologic) images

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Various images and immunostains

Molecular / cytogenetics description
  • t(2;5) of anaplastic large cell lymphoma is not present
Classic Hodgkin lymphoma: mixed cellularity
Microscopic (histologic) description
  • Classic Reed-Sternberg cells with multilobulated nuclei, vesicular chromatin, multiple eosinophilic nucleoli
  • Also mononuclear Reed-Sternberg cells, mature small lymphocytes, eosinophils, plasma cells, immunoblasts

Positive stains
  • CD15, CD30 (membranous and perinuclear globular staining)

Negative stains
Nodular sclerosis
Definition / general
  • Most common subtype in mediastinum

Gross description
  • Pseudoencapsulated with internal fibrous bands
  • Thick capsule if thymus involved; nodular (solitary or multiple)
  • Residual thymic tissue usually present; may form thymic cysts

Microscopic (histologic) description
  • Refractile collagen bands intersect at oblique angles, surround highly atypical mononuclear cells with vesicular nuclei and eosinophilic nucleoli
  • Also small mature lymphocytes, eosinophils, lacunar cells
  • Residual thymic elements also present

Microscopic (histologic) images

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Low power view

Nodular sclerosis type

Polymorphic infiltrate

Classic Reed-Sternberg cells

Mononuclear variants

Fig A: effacement of normal lymph node structure


Positive stains
  • CD15, CD30 (membranous and perinuclear globular staining)

Negative stains