Reed-Sternberg Cells

Reed-Sternberg cells (RS cells) are the cancer cells in Hodgkin lymphoma (HL). This cancer usually forms in the lymph nodes in your neck or chest cavity. But it can also appear in other lymph nodes throughout the body. Only about 1 out of every 100 cells in lymphoma tissue are Reed-Sternberg cells. The rest are white blood cells that cause inflammation where the cancer cells are.

Identifying Reed-Sternberg cells is important to your diagnosis. The presence of these cells is one of the main factors that distinguishes Hodgkin lymphoma from non-Hodgkin lymphoma. This is important since the treatments and disease course for the two lymphomas are very different.

Variants

The classic type of Reed-Sternberg cells is much bigger than normal cells. They have two or more nuclei. “Nuclei” is the plural form of “nucleus.” The nucleus of a cell contains its genetic material, or DNA. When viewed beneath a microscope, the nuclei of classic type RS cells look like a pair of giant owl eyes. But there are variants, too, including:

• Hodgkin cells: These cells only have one nucleus. These cells are so common in Hodgkin lymphoma that doctors sometimes add “Hodgkin” in front of the cell type (Hodgkin Reed-Sternberg cells, or HRS).
• Lacunar cells: The cells contain many small segments called lobes and tiny nuclei. The fluid inside the cell is pale.
• Mummified cells: The fluid inside these cells is oddly thick. And the nuclei are a reddish color when viewed beneath a microscope.

These differences are mostly useful to healthcare providers. The important thing to know is that all these cells relate to Hodgkin lymphoma. So, if a lab report (or your provider) mentions “Hodgkin cells,” know that it’s just a different form of the cancer cell in HL.

What causes Reed-Sternberg cells to form?

Experts believe that RS cells form when the DNA inside B cells changes (mutates). B cells are white blood cells that fight infections by making antibodies. But with Hodgkin lymphoma, there are so many cell changes that the B cell is no longer recognizable.

You acquire these changes in your lifetime. You’re not born with Reed-Sternberg cells.

How do Reed-Sternberg cells work?

Even though they arise from B cells, RS cells and their variants no longer protect you from infections. They’re so abnormal that they just damage healthy tissue. They:

• Make more copies of themselves instead of dying: The Hodgkin cells make malignant clones of themselves. While healthy cells die on a set schedule, the cancer cells keep thriving.
• Escape your immune system defenses: They hide from the white blood cells whose job is to kill cancer cells. This means they don’t die unless treatment destroys them.
• Release chemical signals that attract white blood cells: White blood cells gather around Reed-Sternberg cells. This causes harmful inflammation in your lymph nodes.

What tests do doctors use to identify RS cells?

Specialists in a lab test tumor tissue for signs of Reed-Sternberg cells. These tests check for abnormal genetic material and proteins on the cell surface. Lab tests include:

• Flow cytometry
• Fluorescence in situ hybridization (FISH)
• Immunohistochemistry

What treatments are used to destroy these cells?

Traditional treatments like radiation therapy and chemotherapy destroy RS cells most of the time. This is why Hodgkin lymphoma is often curable. Part of the reason for this may be that Reed-Sternberg cells are so abnormal that they’re unstable. It’s likely hard for them to make repairs after these cancer therapies damage them.

But in rare cases, the RS cells come back. If this happens, you may need treatments designed to attack unique features on RS cells. For example, some treatments deliver toxic chemotherapy to cells that have a protein called CD30. RS cells often have this protein. Some treatments prevent RS cells from escaping your immune system defenses.

Are Reed-Sternberg cells present in non-Hodgkin lymphoma?

No. RS cells are present in Hodgkin lymphoma but not in non-Hodgkin lymphoma.

Are Reed-Sternberg cells B or T cells?

Experts believe that Reed-Sternberg cells mutate from B cells. The cancer starts when B cells transform instead of dying when they’re supposed to. The cells go through so many changes that they don’t resemble healthy B cells at any point during cell development.