Peak years for MCHL are late teens and mid-thirties. Most cases show Epstein-Barr virus in the neoplastic cells. The normal nodal architecture is effaced by a diffuse infiltrate of classic Reed-Sternberg cells mixed with the non-neoplastic cellular background of small lymphocytes, eosinophils, plasma cells, histiocytes, and rarely neutrophils, so characteristic of Hodgkin lymphoma. The RS cells are more frequent in MCHL than lacunar cells in NSHL. Note that the stroma is increased (the amorphous pink background supporting the cells), but does not form collagen bands as in NSHL. The RS cell's production of cytokine TGF-b is thought to contribute to the stromal increase, including the collagen formation in NSHL.
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