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Case 292 - Discussion

Hematopathology Case








Bone Marrow with Metastatic Classic Hodgkin Lymphoma

  • Classic Hodgkin lymphoma does not often metastasize to the bone marrow, only seen in 15-20% of cases;

  • Usually present with fibrosis with scattered Hodgkin lymphoma cells;

  • Need to distinguish Hodgkin lymphoma cells from entrapped megakaryocytes; a most useful feature is that lymphoma cells have large nucleoli, which are usually absent in megakaryocytes. The cytoplasm of lymphoma cells is usually clear with retraction artifact, whereas megakaryocytes have abundant fine granular cytoplasm, often pale pink staining.