Molecular genetics

Classical cytogenetic studies of cHL are often unsuccessful, or demonstrate only a normal karyotype. The failure of such studies to characterize the malignant cells likely is secondary to the difficulty in isolating the neoplastic cells, which typically represent only a small percentage of the cells present, combined with poor growth of the neoplastic cells in culture. When abnor

Figure 71.1 Nodular sclerosis Hodgkin's lymphoma. The lymph node is effaced by a lymphoid proliferation that is separated into nodules by dense collagenous bands of fibrosis (upper left). The nodules contain numerous ReedSternberg cells and mononu-clear variants (upper right). The neoplastic cells are positive for CD30 (lower left) and CD15 (lower right)

Figure 71.1 Nodular sclerosis Hodgkin's lymphoma. The lymph node is effaced by a lymphoid proliferation that is separated into nodules by dense collagenous bands of fibrosis (upper left). The nodules contain numerous ReedSternberg cells and mononu-clear variants (upper right). The neoplastic cells are positive for CD30 (lower left) and CD15 (lower right)

malities are identified, karyotypes are typically quite complex and hypertetraploidy is common.28 29 Specific recurrent abnormalities, however, have not been identified. Clonal rearrangements of the Ig heavy chain are present in the vast majority of cases, although highly specialized, nonstandard laboratory techniques such as microdissection or single-cell PCR studies may be required to demonstrate this finding as noted earlier in this chapter. Cases with clonal T-cell receptor rearrangements appear to be very rare, and the nature of such cases is a matter of controversy.19 In EBV positive cases, clonality of the epstein-barr virus (EBV) genome may also be identified.30

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