Reed-Sternberg cells in classical Hodgkin lymphoma characteristically express CD30 and CD15 but are CD20-negative. The lineage ambiguity of RS cells is explained by the fact that they are derived from:
- A Activated T-helper cells
- B Plasma cells that re-express CD30
- C Germinal center B cells that have undergone crippling somatic hypermutation but escaped apoptosis via EBV or NF-κB activation ✓
- D Follicular dendritic cells that acquired B-cell features
Correct answer: C. Germinal center B cells that have undergone crippling somatic hypermutation but escaped apoptosis via EBV or NF-κB activation
Explanation
Reed-Sternberg cells are derived from germinal center B cells that have acquired 'crippling' (non-functional) somatic hypermutations in their immunoglobulin variable genes, which would normally trigger apoptosis. Survival is rescued either by EBV infection (LMP-1 mimics CD40 signaling) or by constitutive NF-κB activation from mutations in TNFAIP3 or other regulators. The malignant RS cells lose typical B-cell markers (CD20, CD79a) while gaining CD30 and CD15, explaining their unusual phenotype.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.