MACROSCOPIC DESCRIPTION: "Left sacral ala": Two cores of pale tan tissue 11 and 17mm in length and up to 2mm in diameter. A1. (SLS)
MICROSCOPIC DESCRIPTION: Sections show two cores of bone, including periosteum, cortex and medullar. The marrow space is replaced by fibrosis and a polymorphous infiltrate of Hodgkin's cells, lymphocytes and eosinophils. Crush artifact is prominent in many areas. Immunostains confirm that there are numerous CD15+, CD30+, MUM-1+ Hodgkin's cells in a background of numerous CD3+ small T-cells and some CD20+, CD79a+ small B-cells, often in dense sheets. There is no staining for EMA.
DIAGNOSIS: Biopsy of left sacral ala: Classical Hodgkin lymphoma, nodular sclerosis type.