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Small lymphocytic lymphoma with Reed Sternberg cells: a diagnostic dilemma

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Reed Sternberg (RS) cells in the setting of small lymphocytic lymphoma (SLL) can complicate the histopathological diagnosis. We report a case of a man aged 54 years who presented with… Click to show full abstract

Reed Sternberg (RS) cells in the setting of small lymphocytic lymphoma (SLL) can complicate the histopathological diagnosis. We report a case of a man aged 54 years who presented with cervical lymphadenopathy. Resection of the lymph node was performed and sent for histopathological evaluation to a local laboratory. A diagnosis of SLL with Classic Hodgkin's lymphoma (CHL) was made. The medical oncologist who encountered this diagnosis for the first time sent the biopsy blocks to our laboratory for a second opinion. On review of the biopsy and immunohistochemical stains, it showed typical SLL morphology and immunophenotype. Focally, it showed large mononuclear RS type cells; however, no typical background of CHL was seen. The diagnosis was revised to ‘SLL with RS like cells with no convincing evidence of CHL’. The patient was subsequently treated as a case of SLL and no progression was observed on a follow-up of 5 years.

Keywords: sternberg cells; lymphoma; small lymphocytic; reed sternberg; sll; lymphocytic lymphoma

Journal Title: BMJ Case Reports
Year Published: 2017

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