Hodgkin and reed-sternberg cells in bone marrow aspirations of a patient with advanced classical hodgkin lymphoma

Research output: Contribution to journalArticle

Abstract

Classical Hodgkin lymphoma (CHL) is a unique type of lymphoma because of the extraordinary and unexplained scarcity of its neoplastic Hodgkin Reed-Sternberg (HRS) cells that derived from clonal germinal center B cells with rearranged immunoglobulin genes bearing crippling mutations. The occurrence of these cells in the bone marrow aspirations are considered rare. Their presence is an expression of widely disseminated disease and it indicates poor prognosis. We report a case of a 24-year-old female with relapsed Hodgkin lymphoma, after eleven years in remission with the standard chemotherapy regime. She was initially diagnosed during childhood with CHL stage IIIB. On this current presentation, she was noted to have cervical lymphadenopathy during her antenatal check-up. The lymph nodes biopsy confirmed relapse of the disease; however, there was no evidence of bone marrow infiltration. She was given various chemotherapy regimes in which she was refractory to. At this point, repeated bone marrow aspiration interestingly revealed the presence of HRS cells. The immunophenotyping analysis by flow cytometry revealed a small population of cells expressing CD20, CD15, and CD30 that further supported the presence of HRS cells in the bone marrow aspirate. The bone marrow biopsy confirmed infiltration of scattered Reed-Sternberg cells and mononuclear Hodgkin cells in a reactive background. In conclusion, we highlight the presence of the rare HRS cells in this patient with advanced relapsed Hodgkin lymphoma.

Original languageEnglish
Pages (from-to)24-27
Number of pages4
JournalNew Zealand Journal of Medical Laboratory Science
Volume69
Issue number1
Publication statusPublished - 1 Apr 2015

Fingerprint

Reed-Sternberg Cells
Hodgkin Disease
Bone
Bone Marrow
Chemotherapy
Biopsy
Infiltration
Bearings (structural)
Cells
Flow cytometry
Refractory materials
Immunoglobulins
Genes
Drug Therapy
Immunophenotyping
Immunoglobulin Genes
Germinal Center
Bone Marrow Cells
Lymphoma
Flow Cytometry

Keywords

  • Bone marrow aspirates
  • Classical hodgkin lymphoma
  • Flow cytometry
  • Hodgkin reed-sternberg cells

ASJC Scopus subject areas

  • Clinical Biochemistry

Cite this

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title = "Hodgkin and reed-sternberg cells in bone marrow aspirations of a patient with advanced classical hodgkin lymphoma",
abstract = "Classical Hodgkin lymphoma (CHL) is a unique type of lymphoma because of the extraordinary and unexplained scarcity of its neoplastic Hodgkin Reed-Sternberg (HRS) cells that derived from clonal germinal center B cells with rearranged immunoglobulin genes bearing crippling mutations. The occurrence of these cells in the bone marrow aspirations are considered rare. Their presence is an expression of widely disseminated disease and it indicates poor prognosis. We report a case of a 24-year-old female with relapsed Hodgkin lymphoma, after eleven years in remission with the standard chemotherapy regime. She was initially diagnosed during childhood with CHL stage IIIB. On this current presentation, she was noted to have cervical lymphadenopathy during her antenatal check-up. The lymph nodes biopsy confirmed relapse of the disease; however, there was no evidence of bone marrow infiltration. She was given various chemotherapy regimes in which she was refractory to. At this point, repeated bone marrow aspiration interestingly revealed the presence of HRS cells. The immunophenotyping analysis by flow cytometry revealed a small population of cells expressing CD20, CD15, and CD30 that further supported the presence of HRS cells in the bone marrow aspirate. The bone marrow biopsy confirmed infiltration of scattered Reed-Sternberg cells and mononuclear Hodgkin cells in a reactive background. In conclusion, we highlight the presence of the rare HRS cells in this patient with advanced relapsed Hodgkin lymphoma.",
keywords = "Bone marrow aspirates, Classical hodgkin lymphoma, Flow cytometry, Hodgkin reed-sternberg cells",
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T1 - Hodgkin and reed-sternberg cells in bone marrow aspirations of a patient with advanced classical hodgkin lymphoma

AU - Bakheet, Omayma Saad Eldeen

AU - Yusof, Nurasyikin

AU - S. Abdul Wahid, S Fadilah

AU - Abdul Aziz, Suria

PY - 2015/4/1

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N2 - Classical Hodgkin lymphoma (CHL) is a unique type of lymphoma because of the extraordinary and unexplained scarcity of its neoplastic Hodgkin Reed-Sternberg (HRS) cells that derived from clonal germinal center B cells with rearranged immunoglobulin genes bearing crippling mutations. The occurrence of these cells in the bone marrow aspirations are considered rare. Their presence is an expression of widely disseminated disease and it indicates poor prognosis. We report a case of a 24-year-old female with relapsed Hodgkin lymphoma, after eleven years in remission with the standard chemotherapy regime. She was initially diagnosed during childhood with CHL stage IIIB. On this current presentation, she was noted to have cervical lymphadenopathy during her antenatal check-up. The lymph nodes biopsy confirmed relapse of the disease; however, there was no evidence of bone marrow infiltration. She was given various chemotherapy regimes in which she was refractory to. At this point, repeated bone marrow aspiration interestingly revealed the presence of HRS cells. The immunophenotyping analysis by flow cytometry revealed a small population of cells expressing CD20, CD15, and CD30 that further supported the presence of HRS cells in the bone marrow aspirate. The bone marrow biopsy confirmed infiltration of scattered Reed-Sternberg cells and mononuclear Hodgkin cells in a reactive background. In conclusion, we highlight the presence of the rare HRS cells in this patient with advanced relapsed Hodgkin lymphoma.

AB - Classical Hodgkin lymphoma (CHL) is a unique type of lymphoma because of the extraordinary and unexplained scarcity of its neoplastic Hodgkin Reed-Sternberg (HRS) cells that derived from clonal germinal center B cells with rearranged immunoglobulin genes bearing crippling mutations. The occurrence of these cells in the bone marrow aspirations are considered rare. Their presence is an expression of widely disseminated disease and it indicates poor prognosis. We report a case of a 24-year-old female with relapsed Hodgkin lymphoma, after eleven years in remission with the standard chemotherapy regime. She was initially diagnosed during childhood with CHL stage IIIB. On this current presentation, she was noted to have cervical lymphadenopathy during her antenatal check-up. The lymph nodes biopsy confirmed relapse of the disease; however, there was no evidence of bone marrow infiltration. She was given various chemotherapy regimes in which she was refractory to. At this point, repeated bone marrow aspiration interestingly revealed the presence of HRS cells. The immunophenotyping analysis by flow cytometry revealed a small population of cells expressing CD20, CD15, and CD30 that further supported the presence of HRS cells in the bone marrow aspirate. The bone marrow biopsy confirmed infiltration of scattered Reed-Sternberg cells and mononuclear Hodgkin cells in a reactive background. In conclusion, we highlight the presence of the rare HRS cells in this patient with advanced relapsed Hodgkin lymphoma.

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