‘Lacunar cells’ are peculiarly seen in which variety of Hodgkin’s lymphoma?
**Core Concept**
Lacunar cells are a distinctive type of Reed-Sternberg cell variant found in a specific subtype of Hodgkin's lymphoma. These cells are characterized by their unique appearance, with large nuclei and abundant cytoplasm, often surrounded by a clear zone or lacuna.
**Why the Correct Answer is Right**
Lacunar cells are typically seen in classical Hodgkin's lymphoma (cHL), particularly in the nodular sclerosis subtype. This subtype accounts for approximately 80-90% of cHL cases and is more common in young adults. The presence of lacunar cells in cHL is due to their ability to undergo apoptosis, leading to the formation of a clear zone around the cell. This process is thought to be mediated by the interaction between lacunar cells and the surrounding lymphoma microenvironment.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because lacunar cells are not a characteristic feature of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), a distinct subtype of Hodgkin's lymphoma with a different clinical and pathological profile.
**Option B:** This option is incorrect because lacunar cells are not typically seen in mixed cellularity Hodgkin lymphoma, another subtype of classical Hodgkin's lymphoma.
**Option C:** This option is incorrect because lacunar cells are not a characteristic feature of lymphocyte-predominant Hodgkin lymphoma, a subtype of Hodgkin's lymphoma that is more common in older adults.
**Clinical Pearl / High-Yield Fact**
Lacunar cells are a key diagnostic feature of classical Hodgkin's lymphoma, particularly in the nodular sclerosis subtype. Recognizing these cells on histopathology is essential for accurate diagnosis and treatment planning.
**Correct Answer:** D. Nodular sclerosis Hodgkin's lymphoma.