Lacunar cells are variants of Reed-Sternberg cells that are specifically found in
**Core Concept**
Lacunar cells are a morphological variant of Reed-Sternberg cells, which are characteristic of Hodgkin lymphoma. These cells are distinguished by their larger size, abundant cytoplasm, and distinctive lacunar appearance due to the retraction of the cell membrane from the surrounding collagen fibers.
**Why the Correct Answer is Right**
Lacunar cells are specifically found in nodular sclerosis Hodgkin lymphoma (NSHL), a subtype of classical Hodgkin lymphoma. The formation of lacunae around these cells is thought to be due to the retraction of the cell membrane from the surrounding collagen fibers, creating a "lacuna" or empty space. This characteristic morphology is a key diagnostic clue for NSHL.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because lacunar cells are not typically associated with lymphocyte-predominant Hodgkin lymphoma, which has a different immunophenotypic profile and cellular morphology.
**Option B:** This option is incorrect because Reed-Sternberg cells, including lacunar cells, are not characteristic of non-Hodgkin lymphomas, which have a distinct set of cellular and molecular features.
**Option C:** This option is incorrect because while Hodgkin lymphoma can present in various lymph node groups, lacunar cells are specifically associated with nodular sclerosis subtype, not the disease's location or presentation.
**Clinical Pearl / High-Yield Fact**
When evaluating a case of Hodgkin lymphoma, it's essential to recognize the distinctive morphology of lacunar cells, which can help guide the diagnosis towards nodular sclerosis subtype. This is particularly important in the context of lymph node biopsies, where accurate diagnosis can impact treatment decisions.
**Correct Answer: D. Nodular sclerosis Hodgkin lymphoma.**