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Vol. 44. Issue 2.
Pages 301-302 (April - June 2022)
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Vol. 44. Issue 2.
Pages 301-302 (April - June 2022)
Images in Clinical Hematology
Open Access
Reed-Sternberg and Hodgkin cells in bone marrow aspirate from a classical Hodgkin lymphoma patient
Leonardo Rodrigues Oliveira
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Corresponding author at. Leonardo Rodrigues Oliveira Rua Getúlio Guaritá, 130 38025-440 Uberaba, MG, Brazil
, Gabriela Cristina Carmona Hinojosa, Renata Margarida Etchebehere
Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
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A 78-year-old man was referred for evaluation of severe anemia (hemoglobin concentration 6.7 g/dL) and thrombocytopenia (8 × 109 /L), bilateral axillary adenomegaly, and massive hepatosplenomegaly. Bone marrow aspirate revealed trilineage hematopoiesis and the presence of giant bilobed nucleus cells with prominent eosinophilic inclusion-like nucleoli surrounded by lymphocytes (rosetting formation) and large mononuclear cells, resembling Reed-Sternberg and Hodgkin cells, respectively (Figure 1). Axillary lymph node biopsy confirmed classical Hodgkin lymphoma (cHL) diagnosis (CD15+, CD30+, CD20-, CD45-). Bone marrow infiltration by cHL was confirmed by biopsy (Figure 2).

Figure 1.

(A) Reed-Sternberg Cell. Large cell surrounded by multiple lymphocytes in a rosetting formation. (B) Hodgkin Cell. Atypical mononuclear cell flanked by some lymphocytes. Bone marrow aspirate, Leishman stain, 1000 × magnification.

Figure 2.

Immunohistochemistry analysis for CD30 is positive in Reed–Sternberg and Hodgkin cells (arrows). Bone marrow biopsy, 400 × magnification.


Detection of cHL tumor cells in the bone marrow aspirate is uncommon, possibly due to scattered focal lesions and the fibrotic nature of the disease.1,2 Multiple tumor-infiltrating T cells in rosetting arrangement suggest an ineffective T cell response against cHL.3

Xu Zhaodong, B.F. Burns, C. Faught.
Reed-Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma.
Eur J Haematol, 92 (2014), pp. 365-366
S.G. Lee, S.Y. Paik, H.J. Sohn, S.Y. Kim, S.Y. Kong.
Numerous reed-sternberg cells in bone marrow aspirate from a patient with the syncytial variant of nodular sclerosis classical Hodgkin lymphoma.
Int J Hematol, 101 (2015), pp. 107-108
S. Vardhana, A. Younes.
The immune microenvironment in Hodgkin lymphoma: t cells, B cells, and immune checkpoints.
Haematologica, 101 (2016), pp. 794-802
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Hematology, Transfusion and Cell Therapy

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