<prompt> Lacunar type of Reed-Sternberg RS cells are seen in which type of Hodgkins lymphoma?Nodular sclerosisLymphocyte predominanceLymphocyte depletionMixed cellularity  <response>: Ans a Nodular Sclerosis Ref. Robbins Pathology 8thTable 12-8.; 7thtable 14-6SubtypeMorphotogy and ImmunophenotypeTypical Clinical FeaturesNoduiar selerosisFrequent lacunar cells and occasional diagnostic R-S cells: background infiltrate composed of T lymphocytes, eosinophils, macrophages and plasma cells, fibrous bands dividing cellular areas into nodules. R-S cells CD15, CD30, EBV.Stage 1 or 2 disease most common. Ferquent mediastinal involvement F M, most patients young adultsMixed cellularityFrequent mononuclear and diagnostic R-S cells; background infiltrate in T lymphocytes, eosinophils, macrophages, plasma cells. R-S cells CD15, CD30; 70 EBV.More than 50 present as stage 3 or 4 disease. MF. Biphasic incidence, peaking in young adults and again in adults older than 55.Lymphocyte-richFrequent mononuclear and diagnostic R-S cells; background infiltrate rivh in T lymphocytes. R-C cells. CD15, CD30; 40 EBV.Uncommon. MF. Tends to be seen in older adults.Lymphocyte depletionReticular variant: Frequent diagnostic R-S cells and variants with a paucity of background reactive cells; diffuse fibrosis variant; hypocellular fibrillary background with scattered diagnostic R-S cells and variants and few reactive cells. R-S cells CD15, CD30; most EBV.Uncommon. More common in older males, HIV-infected individuals, and in developing countries. More likely to present with advanced disease.Lymphocytes predominanceFrequent 1 II popcorn cell variants in a background of follicular dendritic cells and reactive B cells. R-S cells CD20. CD15, C30; EBV.Uncommon. Young males with cervical or axillary lymphadenopathy. Mediastinal.SUMMARY OF THE MORE COMMON LYMPHOID NEOPLASMSEntityFrequencySalient MorphologyImmunophenotypeCommentsPrecursor B-cell lym- phoblastic leukemia lymphoma85 of childhood acute leukemiaLymphoblasts with irre- gular nuclear contours, condensed chromatin, small nucleoli, and scant agranular cytoplasmTdTimmature B cells CD19, variable expression of other B-cell markersUsually presents as acute leukemia; less common in adults; prognosis is predicted by karyotypePrecursor T-cell leukemia lymphoma15 of childhood acute leukemia; 40 of child- hood lymphomasIdentical to precursor B-cell lymphoblastic leukemialymphomaTdTimmature T cells CD2, CD7, variable expression of other T-cell markersMost common in adolescent males; often presents as a mediastinal mass due to thymic involvement; asso with NOTCH1 mutationSmall lymphocytic lymphomachronic lymphocytic leukemia3 to 4 of adult lymphomas; 30 of all leukemiasSmall resting lymphocytes mixed with variable numbers oflarge activated cells; lymph nodes diffusely effacedCD5B-cell expressing surface IgOccurs in older adults; usually involves nodes, marrow, and spleen; most patients have peripheral blood involvement; indolentFollicular lymphoma40 of adult lymphomasFrequent small cleaved cells mixed with large cells; growth pattern is usually nodular follicularCD10BCL2mature B cells that express surface IgOccurs in older adults; usually involves nodes, marrow, and spleen; associated with t14;18; indolentMantle cell lymphoma3 to 4 of adult lymphomasSmall to intermediate- sized irregular lymphocytes growing in a diffuse patternCD5mature B cells that express cyclin D1 and have surface IgOccurs mainly in older males; usually involves nodes, marrow, and spleen; GI tract also commonly affected; t11;14 is characteristic; moderately aggressiveExtranodal marginal zone lymphoma5 of adult lymphomasVariable cell size and differentiation; 40 show plasmacytic differentiation; B cells home to epithelium, creating lymphoepithelial lesionsCD5- CD10- mature B cells with surface IgFrequently occurs at extranodal sites involved by chronic inflammation; very indolent; may be cured by local excisionDiffuse large B-cell lymphoma40 to 50 of adult lymphomasVariable; most resemble large germinal center B cells; diffuse growth patternMature B cells with variable expression of CD10 and surface IgOccurs in all ages, but most common in older adults; often arise at extranodal sites; aggressiveBurkitt lymphoma1 of lymphomas in the United StatesIntermediate-sized round lymphoid cells with several nucleoli; diffuse tissue involvement associated with apoptosis produces a starry-sky appearanceMature CD10B cells expressing surface IgEndemic in Africa, sporadic elsewhere; increased frequency in immunosuppressed patients; predominantly affects children; often presents with visceral involvement; highly aggressivePlasmacytoma plasma cell myelomaMost common lymphoid neoplasm in older adultsPlasma cells in sheets, sometimes with prominent nucleoli or inclusions containing IgTerminally differentiated plasma cells containing cytoplasmic IgMyeloma presents as disseminated bone disease, often with destructive lytic lesions. Hypercalcemia, renal insufficiency, and bacterial infections are commonMycosis fungoidesMost common cutaneous lymphoid malignancyIn most cases, small lymphoid cells with markedly convoluted nuclei; cells often infiltrate the epidermis Pautrier microabscessesCD4mature T cellsPresents with localized or more generalized skin involvement; generally indolent. Sezary syndrome, a more aggressive variant, is characterized by diffuse skin erythema and peripheral blood involvementPeripheral T-cell lymphoma, not otherwise specified NOSMost common adult T-cell lymphomaVariable; usually a spectrum of small to large lymphoid cells with irregular nuclear contoursMature T-cell phenotype CD3Probably spans a diverse collection of rare tumors. Often disseminated, generally aggressive 