Some differences between Reed- sternberg (RS) cells and RS-like cells

What are Reed-Sternberg cells or RS-cells?

Various types of Reed-Sternberg cells.

Many a times RS-like cells may appear in conditions unrelated to Hodgkinโ€™s Lymphomas. It is important to be aware of RS-cells and their mimics.

Some clues useful in differentiating RS cells from RS like cells

FeaturesRS cellsRS like- cells
Associated conditionsSeen in HL/composite lymphomasMay be seen in high grade lymphomas, rarely in low grade B- or T-cell NHLs
BackgroundShould be accompanied by characteristic background (fibrosis, inflammatory cells)No characteristic background
CD 30 expressionStrong and homogenous CD30CD 30 variable expression
B- cell expression.Negative/variable positive for B-cell markersB-cell markers more
homogenously expressed (CD20, CD79a, PAX-5)
RS cells vs RS-like cells

Now on to the most difficult task

Identify the True RS-cell

Choose one

Correct answer is B. RS cells have a characteristic eosinophilic nucleoli and a polymorphous background. Option A- Horseshoe shaped cells in ALCL. Option C- EBV positive cells associated with EBV positive mucocutaneous ulcer, basophilic nucleoli. Option D: Diffuse large B cell lymphoma.

RS cells can be identified by routine hematoxylin and eosin staining, however, IHC for CD 15,CD30, CD20 and CD 45 can be useful in their differentiation from RS-like cells.

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