This histopathology image depicts a lymph node biopsy showing features diagnostic of lymphocyte-depleted classic Hodgkin lymphoma, reticular subtype. Using light microscopy on an H&E-stained paraffin section, the lymphoid architecture is markedly effaced by a cellular sheet of large, atypical mononuclear cells with prominent nucleoli. Occasional Reed-Sternberg cells are visible within the expansive background, including cells with multilobed or bilobed nuclei and prominent eosinophilic nucleoli, characteristic of Hodgkin lymphoma. The RS cells are scattered among numerous atypical mononuclear variants rather than forming a cohesive nodular structure. There is little-to-no fibrosis and only sparse non-neoplastic inflammatory cells, which is typical for the lymphocyte-depleted pattern. The background may show rimming by small lymphocytes and histiocytes in a reticular network, but overall cellularity is high. Immunophenotypic markers are not shown here, but in clinical practice RS cells typically express CD30 and CD15 with weaker PAX5 or B-cell markers. The diagnostic significance lies in recognizing the lymphocyte-depleted cHL morphology, which carries distinct clinical implications, often presenting with advanced stage disease and systemic symptoms. This image is useful for educational purposes, differential diagnosis conversation, and correlating histology with treatment planning (ABVD/BEACOPP regimens). Correlation with immunohistochemistry (CD30, CD15, PAX5) and EBV status further supports diagnosis in practice.

This brightfield histopathology image depicts a lymph node biopsy illustrating a histiocyte-rich variant of mixed cellularity classical Hodgkin lymphoma. The tissue is sectioned and stained with hematoxylin and eosin, viewed at low-to-intermediate magnification, revealing a densely cellular background with a prominent infiltrate of histiocytes and epithelioid macrophages forming aggregates, accompanied by scattered eosinophils, lymphocytes, plasma cells, and occasional neutrophils. The classic Reed-Sternberg cells are present but may be sparse within the abundant histiocytic milieu, with multilobed nuclei and prominent nucleoli. The architectural pattern is polymorphic rather than nodular, lacking prominent fibrous bands characteristic of nodular sclerosis. The histiocyte-rich variant features abundant macrophages mirroring granulomatous-like features, potentially mimicking inflammatory conditions; however, residual neoplastic Hodgkin cells in this setting bear the typical immunophenotype (CD30+, CD15+, PAX5 weak) in adjacent areas. Clinically, this histology correlates with mixed cellularity Hodgkin lymphoma, a B-cell origin neoplasm presenting with constitutional symptoms and lymphadenopathy. The image is relevant for educational demonstration of HL subtypes, differential diagnoses with non-Hodgkin lymphomas and granulomatous processes, and for training in histopathologic recognition, pattern recognition, and morphologic correlation with immunophenotype and clinical findings. Immunohistochemistry supports diagnosis by highlighting Reed-Sternberg cells (CD30+, CD15+, PAX5 weak) amid a histiocyte-rich background; EBV association may be variable; clinical staging and treatment follow Hodgkin lymphoma guidelines.

This high-power light micrograph of a lymph node biopsy, stained with Hematoxylin and Eosin, demonstrates classical Hodgkin lymphoma histology. The tissue is densely cellular with a polymorphic inflammatory background comprising small lymphocytes, eosinophils, plasma cells, and histiocytes. Scattered among the background are large binucleated Reed-Sternberg (RS) cells exhibiting prominent, mirror-image eosinophilic nucleoli and ample cytoplasm, giving an owl's eye appearance. Mononuclear RS variants with similar nuclear features are present, reflecting heterogeneity within the malignant cell population. The RS cells may appear with delicate nuclear membranes and occasional lobulation. The surrounding milieu often includes reactive T-lymphocytes and occasional eosinophils attracted by cytokines produced by RS cells. The overall architecture lacks well-formed nodules, and the background shows a mixed inflammatory infiltrate, characteristic of classical Hodgkin lymphoma subtypes such as mixed cellularity. Important differential considerations include infectious or benign reactive processes, but the presence of RS cells with classic morphology supports a diagnosis of classical HL. Clinically, these findings correlate with nodal enlargement and B symptoms in many patients, and histology guides staging and therapy decisions, including chemotherapeutic regimens such as ABVD and potential radiotherapy in select cases. Correlation with immunohistochemistry and clinical data improves diagnostic confidence and treatment planning for patient care.

This histopathology image depicts recurrent nodular sclerosis classical Hodgkin lymphoma (cHL) on a hematoxylin and eosin stained lymph node biopsy. The tissue is examined under brightfield light microscopy at high-power fields; the nodular architecture is demonstrated by fibrous bands creating discrete nodules with collagenous sclerosis. Within the nodules, numerous classic Reed-Sternberg (RS) cells are present, frequently bi- or multinucleated with prominent eosinophilic nucleoli and ample cytoplasm; lacunar variants may be observed. The background shows a mixed inflammatory milieu including lymphocytes, plasma cells, neutrophils, eosinophils, and histiocytes; eosinophil-rich infiltrate is characteristic of cHL. Immunophenotype typical of RS cells is implied but not shown here: CD30 and CD15 positivity with PAX5 dim/weak positivity and variable CD20 negativity, helping distinguish cHL from other lymphoproliferative disorders. The sclerosis pattern and RS cell morphology, in the appropriate clinical context, support a relapse rather than a de novo lymphoma; however, post-therapy changes can alter cellular composition. This image underlines the importance of correlating histology with prior treatment history and immunohistochemistry to confirm relapse, guide staging, and inform therapy decisions, including salvage regimens or autologous stem cell transplantation considerations. Correlating morphology with immunophenotype and clinical history is essential for accurate relapse assessment. This informs prognosis and therapeutic strategy.

Imaging modality: bright-field light microscopy of a hematoxylin and eosin stained lymph node biopsy section viewed at high magnification. The tissue displays nodular sclerosis—nodules of lymphoid cells separated by thick bands of collagen—typical of classic Hodgkin lymphoma. The background comprises a mixed inflammatory infiltrate including eosinophils, neutrophils, small lymphocytes, plasma cells, and histiocytes. Fibroblasts are present within the fibrous bands and contribute to sclerosis. Notable features include multinucleated Reed–Sternberg cells, often with prominent nucleoli, located centrally in nodules; occasional lacunar variants may be seen in deeper sections. Eosinophilic and sometimes neutrophilic microabscesses are common in the nodular background and can obscure or mimic necrotizing granulomas at low magnification. The cellular composition varies between nodules, producing a heterogeneous appearance. This histology supports a diagnosis of nodular sclerosis type of classic Hodgkin lymphoma when combined with immunophenotypic data (CD15+, CD30+, PAX5 weak). Diagnostic significance lies in identifying RS cells within a reactive milieu; differential diagnoses include granulomatous inflammation and other lymphomas. Clinically, this pattern often correlates with mediastinal or peripheral lymphadenopathy in young adults and informs staging, prognosis, and chemotherapy decisions. In sum, lymphoid nodules with fibrous septa and RS cells characterize nodular sclerosis HL.

This light microscopic histopathology image depicts lymph node tissue stained with Hematoxylin and Eosin, examined at low magnification to emphasize nodular architecture characteristic of nodular sclerosis classical Hodgkin lymphoma. The sample reveals prominent nodularity with broad, concentric bands of hyalinized collagen that enclose discrete cellular nodules. Within these nodules, clusters of lacunar variant Reed-Sternberg cells are evident, accompanied by a sparsely cellular inflammatory background. The nodules display a mottled or moth-eaten appearance due to variable density of malignant RS cells and associated microabscesses or small foci of necrosis. The thick fibrous bands give the lymph node a fibrotic, polarized halo around nodules; in polarized light, the collagen may appear birefringent, highlighting the sclerosis. Overall the image demonstrates hallmarks of NSCHL: nodular sclerosis pattern, lacunar RS cells, and a desmoplastic stroma with dense collagen bands. Clinically, this pattern is associated with mediastinal involvement in younger patients and a favorable prognosis when treated appropriately. This histology is essential for differential diagnosis against other Hodgkin lymphoma subtypes (mixed cellularity, lymphocyte-rich) and against non-Hodgkin lymphomas. The image is relevant for pathology education, diagnostic pathology practice, and tumor biology research. Correlation with immunohistochemical profile and clinical staging enhances diagnostic confidence. Useful for teaching and research applications.