Lacunar cells is seen in which type of Hodgkins Lymphoma: September 2010
**Core Concept**
Lacunar cells are a distinctive type of Reed-Sternberg cell variant, characteristic of a specific subtype of Hodgkin's lymphoma. They are identified by their large size, abundant cytoplasm, and characteristic "lacuna" or empty space around the nucleus.
**Why the Correct Answer is Right**
Lacunar cells are a hallmark of classical Hodgkin's lymphoma, specifically the nodular sclerosis subtype. These cells are derived from germinal center B cells that have undergone neoplastic transformation. The lacuna is thought to result from shrinkage of the cell during processing, making it an important diagnostic feature. Lacunar cells are typically CD30 and CD15 positive, which aids in their identification.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because lacunar cells are not typically associated with lymphocyte-predominant Hodgkin's lymphoma, which is characterized by lymphocytic and histiocytic (L&H) Reed-Sternberg cells, also known as "popcorn cells."
**Option B:** This option is incorrect because mixed cellularity Hodgkin's lymphoma is characterized by a mixture of cell types, including classic Reed-Sternberg cells, but not typically lacunar cells.
**Option C:** This option is incorrect because lymphocyte-depleted Hodgkin's lymphoma is characterized by a paucity of lymphocytes and an abundance of Reed-Sternberg cells, but not typically lacunar cells.
**Clinical Pearl / High-Yield Fact**
Lacunar cells are a critical diagnostic feature of nodular sclerosis Hodgkin's lymphoma, and their presence can help differentiate this subtype from other forms of lymphoma.
**Correct Answer: C. Nodular sclerosis.**