Reed–Sternberg cells (also known as lacunar histiocytes for certain types) are different giant cells found with light microscopy in biopsies from individuals with Hodgkin's lymphoma (aka Hodgkin's disease; a type of lymphoma). They are usually derived from B lymphocytes, classically considered crippled germinal center B cells, meaning they have not undergone hypermutation to express their antibody. Seen against a sea of B cells, they give the tissue a moth-eaten appearance.
Reed–Sternberg cells are large and are either multinucleated or have a bilobed nucleus (thus resembling an "owl's eye" appearance) with prominent eosinophilic inclusion-like nucleoli. Reed–Sternberg cells are CD30 and CD15 positive, usually negative for CD20 and CD45. The presence of these cells is necessary in the diagnosis of Hodgkin's lymphoma – the absence of Reed–Sternberg cells has very high negative predictive value. They can also be found in reactive lymphadenopathy (such as infectious mononucleosis, carbamazepine associated lymphadenopathy) and very rarely in other types of non-Hodgkin lymphomas.
A special type of Reed–Sternberg cells (RSCs) is the lacunar histiocyte, whose cytoplasm retracts when fixed in formalin, so the nuclei give the appearance of cells that lie with empty spaces (called lacunae) between them. These are characteristic of the nodular sclerosis subtype of Hodgkin's lymphoma.
Mummified RSCs (compact nucleus, basophilic cytoplasm, no nucleolus) are also associated with classical Hodgkin's lymphoma while popcorn cells (small cell with hyper-lobulated nucleus and small nucleoli) are associated with Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL).
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