Syncytial variant Hodgkin lymphoma의 세침흡인 세포학적 소견 -1예 보고-

초록

The nodular sclerosis Hodgkin lymphoma (NSHL) is characterized by lacunar RS cell variants and birefrigent fibrous bands subdividing the node into cellular nodules. The syncytial variant of NSHL is an extreme form of the cellular phase of NSHL, in which numerous R-S cells of classic and variant type are arranged in cohesive clusters or sheets, producing appearance of metastatic carcinoma, anaplastic large cell lymphoma or malignant melanoma. Most, if not all, cases of the syncytial variants would be classified as grade 2 NSHL by the British National Lymphoma Investigation , but grading of NSHL is not used widely.We describe cytologic findings of a case we recently experienced. The patient was 26-year-old male who presented with a firm and fixed supraclavicular mass detected about 2 weeks before. He denied recent fever, night sweat or weight loss. He had a history of pulmonary tuberculosis 7 years ago. The fine needle aspirate disclosed malignant cells in the background with some reactive lymphoid cells. The tumor cells occurred singly and in cohesive clusters. They were large, with moderate amount of pale-staining cytoplasm. Their nuclei were some what vesicular with some lobulation and occasional prominent nucleoli. Excised lymph nodes showed histopathologic features of grade 2 nodular sclerosis Hodgkin lymphomas, that could be misinterpreted as anaplastic large-cell lymphoma Hodgkin-like. The lymph node was diffusely effaced with nodular formations of R-S cells of variant type accompanied by fibrosis and extensive necrosis.