Reed Sternberg Cells: Abnormal Reaction of the Immune System

Reed Sternberg cells or R-S cells are a type of lymphoid cell whose presence indicates a medical condition known as Hodgkin’s lymphoma. The characteristics of Reed Sternberg cells were first established by Carl Sternberg and Dorothy Reed. Hence the cells are known as Reed Sternberg cells. The presence of Reed Sternberg cells can indicate other medical conditions apart from Hodgkin’s lymphoma, since they can be present in a number of conditions. So their presence does not exclusively indicate Hodgkin’s lymphoma. But their presence is essential for a Hodgkin’s lymphoma diagnosis.

Basic components of cells

In order to know the structure and functioning of the Reed Sternberg cell, it is important to

Reed Sternberg cells
Micrograph showing a classic Reed Sternberg cell. Source: Wikipedia.org

understand the basic structure of a cell. Cells are the smallest components in a living organism. They are usually covered with a porous membrane called cell membrane which separates each cell from other cells. Within a cell, there is a central component called a nucleus which acts as a control center for the entire cell. The nucleus is contained in a nuclear membrane which separates it from the fluid called cytoplasm present in the rest of the cell. Within the nucleus, there is a nucleolus which contains genetic material called Ribonucleic Acid or RNA. Cells also contain components such as vacuoles, mitochondria, and Golgi bodies, each component serving a different function within a cell.

Origin and description of Reed Sternberg cells

As mentioned earlier, Reed Sternberg cells are lymphoid cells. Lymphoid cells are cells responsible for producing immunity in vertebrates, often in conjunction with other cells or antibodies. Lymphocytes, which are a type of white blood cells, are lymphoid cells. Some other types of lymphoid cells are lymphoblasts and plasma cells.

Lymphoid cells are not granular in nature. Hence they are also called agranulocytes. The cytoplasm present in a lymphoid cell is transparent, and the nucleus is compact. In cases where a lymphoid cell is a Reed Sternberg cell, the cell is usually very large, containing a large amount of granular cytoplasm which is pale. The cell also contains more than one lobed nucleus with large nucleoli.

Relation between lymphocytes and Reed Sternberg cells

Lymphocytes are classified into two types – large and small. Natural Killer cells (or NK cells) are a type of large lymphocytes, while small lymphocytes include T cells and B cells. Reed Sternberg cells are formed in most cases from B cells of lymphocytes. Apart from Hodgkin’s lymphoma, there are several other kinds of lymphoma, often involving the B and T lymphocytes, collectively known as Non-Hodgkin lymphoma or NHL.

What is Hodgkin’s lymphoma?

Lymphoma is a type of cancer involving lymphocytes. Lymphomas appear as tumors of lymphoid cells. In case of Hodgkin’s lymphoma, malignant tumors are formed from lymphoid cells, leading to the presence of Reed Sternberg cells. Thus Hodgkin’s lymphoma may be described as a neoplastic proliferation or abnormal growth of certain lymphoid cells, with the term neoplastic being derived from the Greek term “neoplasia” meaning new growth. Neoplasia may lead to the formation of benign, pre-malignant, or malignant tumors.

Therefore, Hodgkin’s lymphoma may be considered an abnormal reaction of the immune system to certain influences or stimuli. As a result of this, certain lymphoid cells undergo abnormal growth leading to the formation of malignant tumors which are named Reed Sternberg cells. These Reed Sternberg cells are the findings in microscopic examination or biopsies for patients with Hodgkin’s lymphoma.

Cell mechanism in Hodgkin’s lymphoma

In Hodgkin’slymphoma there are two types of components – tumor and a part outside the tumor. The tumor component, of course, is the Reed Sternberg cell which can be in both typical and variant form. The non-tumor component or reactive component can consist of normal lymphocytes, plasma cells, or other types of white blood cells such as eosinophils or neutrophils.

The Reed Sternberg cell which is most common has a size ranging from 20 to 50 microns, with fine, granular, homogenous cytoplasm and nuclei which are mirror images of each other (and therefore called “owl eyes”).

The variants of the Reed Sternberg cell are as follows:

  1. Hodgkin’s cell or atypical Reed Sternberg cell which has all the characteristics of a Reed Sternberg cell, but is mono-nucleated.
  2. Reed Sternberg cells which are large and have a single nucleus. Around the nucleus, the cytoplasm is retracted, giving an impression of empty spaces.
  3. A type of Reed Sternberg cell that has irregular shaped multiple nuclei.
  4. A type of Reed Sternberg cell which, unlike other variants of the Reed Sternberg cell, is not a large cell. It has a nucleus with many lobes.
  5. A type of Reed Sternberg cell with a nucleus that does not have lobes. It has no nucleoli.

Symptoms and risk factors for Hodgkin’s lymphoma

Hodgkin’s lymphoma is characterized by swollen lymph nodes whose effects often become exaggerated after consumption of alcohol. Weight loss, fever, breathing trouble and general fatigue that persist for no apparent reason are other symptoms of the condition.

Although it is not possible to pinpoint a reason why an individual develops Hodgkin’s lymphoma, there are certain risk factors associated with the condition, namely, infection with the Epstein Barr Virus (EBV) or the Human Immunodeficiency Virus (HIV), a generally weak immune system, and a family history of the condition.

Treatment and survival rates

Hodgkin’s lymphoma can be treated with radiation therapy, chemotherapy, or even certain kinds of stem cell transplantation, the last being reserved for life-threatening situations. The type of treatment to be used depends on the age and sex of the patient, and the stage of the disease.

Survival rates, too, depend on several factors, one of the most important being the mode of treatment. Radiation therapy and some chemotherapy drugs are potentially hazardous, often leading to secondary cancers and heart and lung diseases many years after the original treatment. Some modern methods of treatment preclude these side effects.

Moreover, since the condition seems to affect people in two age groups – young adults (15-35) and over 55 years – there might be a better potential for recovery among younger patients.

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