The most reliable characteristics of the Reed Sternberg cell are the large inclusion like nucleloi and the double or multiple nuclei of large size. A peculiar clear zone about the nucleolus is tipically large and spherical, with smooth margins and homogeneous eosinophilic or amphophilic staining characteristics. The Reed Sternberg cells may vary considerably in their morphological apperance, depending on the histological subtype. This and other refinements have permitted the development of the Rye histopathological classification. Clinical Manifestations Constitutional symptoms may accompany the diagnosis of Hodgkin s Disease.
Fevers are usually low grade and irregular.
Rarely, a cyclic pattern of high fevers for 1 to 2 weeks alternating with afebrile periods of similar lengh is present at diagnosis. This classic Pel Ebstein fever is virtually diagnostic. Generalized pruritus, often accompanied by marked excoriation, may be present at diagnosis. Pain in involved lymph nodes immediately after the ingestion of alcohol is a curious complaint that is nearly specific to Hodgkin s Disease. Patients with intrathoracic disease may present with cough, chest pain, dyspnea, and, rarely hemoptysis.