Reed–Sternberg cells (also known as lacunar histiocytes for certain types) are distinctive,
giant cells found with
light microscopy in
biopsies from individuals with
Hodgkin lymphoma. They are usually derived from
B lymphocytes, classically considered crippled
germinal center B cells. In the vast majority of cases, the
immunoglobulin genes of Reed–Sternberg cells have undergone both
V(D)J recombination
V(D)J recombination (variable–diversity–joining rearrangement) is the mechanism of somatic recombination that occurs only in developing lymphocytes during the early stages of T and B cell maturation. It results in the highly diverse repertoire ...
and
somatic hypermutation, establishing an origin from a germinal center or postgerminal center B cell. Despite having the genetic signature of a B cell, the Reed–Sternberg cells of classical Hodgkin lymphoma fail to express most B-cell–specific genes, including the immunoglobulin genes. The cause of this wholesale reprogramming of gene expression has yet to be fully explained. It presumably is the result of widespread epigenetic changes of uncertain etiology, but is partly a consequence of so-called "crippling" mutations acquired during
somatic hypermutation. Seen against a sea of B cells, they give the tissue a moth-eaten appearance.
Reed–Sternberg cells are large (30–50 microns) and are either multinucleated or have a bilobed
nucleus with prominent
eosinophilic inclusion-like
nucleoli
The nucleolus (; : nucleoli ) is the largest structure in the nucleus of eukaryotic cells. It is best known as the site of ribosome biogenesis. The nucleolus also participates in the formation of signal recognition particles and plays a ro ...
(thus resembling an "owl's eye" appearance). Reed–Sternberg cells are
CD30 and
CD15 positive except in the lymphocyte predominance type where they are negative, but are usually positive for
CD20 and
CD45. The presence of these cells is necessary in the diagnosis of Hodgkin lymphoma – the absence of Reed–Sternberg cells has very high
negative predictive value. The presence of these cells is confirmed mainly by use of biomarkers in
immunohistochemistry
Immunohistochemistry is a form of immunostaining. It involves the process of selectively identifying antigens in cells and tissue, by exploiting the principle of Antibody, antibodies binding specifically to antigens in biological tissues. Alber ...
. They can also be found in reactive
lymphadenopathy
Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. In c ...
(such as
infectious mononucleosis
Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV). Most people are infected by the virus as children, when the disease produces few or no symptoms. In young adu ...
immunoblasts which are RS like in appearance, and in
carbamazepine associated lymphadenopathy) and very rarely in other types of non-Hodgkin lymphomas. Anaplastic large cell lymphoma may show RS-like cells as well.
History
They are named after
Dorothy Reed Mendenhall and
Carl Sternberg, who provided the first definitive microscopic descriptions of Hodgkin's disease.
Pathology
Hodgkin lymphoma
A special type of Reed–Sternberg cell (RSC) is the ''lacunar histiocyte'', whose cytoplasm retracts when fixed in formalin, so the nuclei give the appearance of cells that lie with empty spaces (called ''lacunae'') between them.
[ 8th edition.] These are characteristic of the
nodular sclerosis subtype of Hodgkin lymphoma.
[
Mummified RSCs (compact nucleus, basophilic cytoplasm, no nucleolus) are also associated with classical Hodgkin lymphoma while popcorn cells (small cell with hyper-lobulated nucleus and small nucleoli) are lymph histiocytic (L-H) variant of Reed–Sternberg cells and are associated with nodular lymphocyte predominant Hodgkin lymphoma (NLPHL).
RSCs and one RSC cell line (L1236 cells) but not other RSC cell lines express very high levels of ]ALOX15
ALOX15 (also termed arachidonate 15-lipoxygenase, 15-lipoxygenase-1, 15-LO-1, 15-LOX-1) is, like other lipoxygenases, a seminal enzyme in the metabolism of polyunsaturated fatty acids to a wide range of physiologically and pathologically import ...
(i.e., 15-lipoxygenase-1) or possibly ALOX15B (i.e. 15-lipoxygenase-2), enzymes that metabolize arachidonic acid and various other polyunsaturated fatty acids to a wide array of bioactive products including in particular those of the 15-Hydroperoxyeicosatetraenoic acid family of arachidonic acid metabolites. This is unusual in that lymphocytes typically express little or no ALOX15. It is suggested that ALOX15 and/or ALOX15B, perhaps operating through one of its arachidonic acid-derived products, the eoxins, contributes to the development and/or morphology of Hodgkin lymphoma.[Exp Hematol. 2010 Feb;38(2):116–23. ]
See also
* Non-Hodgkin lymphoma
* Hodgkin lymphoma
References
{{DEFAULTSORT:Reed-Sternberg cell
Histopathology
Hodgkin lymphoma