Reed-Sternberg Cells are Characteristic of Hodgkin Lymphoma
The correct answer is C) Hodgkin lymphoma. Reed-Sternberg cells are the pathognomonic, disease-defining feature of classic Hodgkin lymphoma (cHL), present in an inflammatory background, and are essential for diagnosis 1, 2.
Pathological Definition
Classic Hodgkin lymphoma, which accounts for 95% of all Hodgkin lymphoma cases, is specifically characterized by the presence of Hodgkin and Reed-Sternberg (HRS) cells 2. These cells are:
- Large, atypical cells that are often binucleated or multinucleated
- Display prominent eosinophilic nucleoli and abundant cytoplasm
- Create the classic "owl's eye" appearance 3
- Represent less than 10% of total tumor cellularity but are pathobiologically dominant 3
Immunophenotypic Profile
The HRS cells have a distinctive immunophenotype that aids in diagnosis 2:
- CD30: Consistently positive (strong and uniform expression)
- CD15: Frequently positive
- CD20: Occasionally positive
- CD45: Negative
- PAX5: Partially retained, reflecting lineage dysregulation 3
This immunophenotype pattern is critical for distinguishing cHL from other lymphomas.
Why Not the Other Options
Diffuse large B-cell lymphoma (DLBCL), hairy cell leukemia, and MALT lymphomas do not contain Reed-Sternberg cells. While Reed-Sternberg-like cells can occasionally appear in some non-Hodgkin lymphomas, these are scattered elements without the typical background microenvironment of cHL and represent a diagnostic challenge rather than a characteristic finding 4, 5.
Clinical Caveat
Important pitfall: Reed-Sternberg-like cells (RSLCs) can rarely appear in B-cell and T-cell non-Hodgkin lymphomas 4, 5. However, in NHLs, these cells typically appear as scattered elements without the characteristic inflammatory background of Hodgkin lymphoma, and the background population shows different characteristics (e.g., monomorphic CD20+ cells in B-cell NHL) 4.