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Clinical Problem Solving: Pathology
October 2001

Diagnosis Pathology Quiz Case

Arch Otolaryngol Head Neck Surg. 2001;127(10):1282. doi:

Hodgkin lymphoma, which is most commonly seen in young adults, can have a variety of presentations. Lymphomas are the most common cause of pediatric mediastinal masses, with approximately two thirds of all pediatric cases of Hodgkin lymphoma involving the mediastinum.1 Otolaryngologists are often involved in the diagnosis of lymphoma, because painless cervical adenopathy is one of the most common initial findings. The malignant cells in Hodgkin lymphoma are thought to be Reed-Sternberg (RS) cells and/or their mononuclear predecessors and are believed to be of B-cell origin in most cases. 2 The classic RS cells are binucleate or multinucleate giant cells with large prominent nucleoli and abundant pale cytoplasm.3 However, there are a number of RS-cell variants, including mononuclear variants, "mummified" variants, lacunar cells, and "popcorn" cells.