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Reed-Sternberg cells on your biopsy report | CION Cancer Clinics
Reed-Sternberg cells are large abnormal cells that mark classical Hodgkin lymphoma. If your biopsy report names them and the marker stains such as CD30 and CD15 fit, the diagnosis is classical Hodgkin lymphoma. The finding does not give the stage or your outlook. Scans and blood tests do that next. Here is what the cells are and what to ask. At CION Cancer Clinics, our haematology team plans myeloma and lymphoma care with you, discussed at a tumour board and explained in plain words.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What does it mean if Reed-Sternberg cells are found?
- Which related cells might my report mention?
- Is seeing the cell enough to make the diagnosis?
- What does the finding tell you, and what does it not?
- What do families often misunderstand about this finding?
- What happens after the report is ready?
- What can this page not tell you?
- Common questions about Reed-Sternberg cells
The short answer
What does it mean if Reed-Sternberg cells are found?
Reed-Sternberg cells are large abnormal cells that are the hallmark of classical Hodgkin lymphoma. If your biopsy report says they were found, and the marker stains fit, the pathologist is telling you the diagnosis is classical Hodgkin lymphoma, a cancer of the lymph glands.
What the cells are
They start from B cells, a kind of white blood cell that normally makes antibodies. Something goes wrong inside them, and they stop behaving like normal B cells. They grow large, often with two or more nuclei, the control centre of a cell. Under the microscope a classic one can look like a pair of owl's eyes staring back.
Why the lymph node looks crowded
The strange thing about Hodgkin lymphoma is that the cancer cells are a small minority. Reed-Sternberg cells send out signals that pull in large numbers of normal immune cells. Most of the swelling you can feel in a gland is these normal cells, gathered around a few abnormal ones. That is also why the diagnosis can be hard to make from a small sample.
Finding these cells is a diagnosis, not a stage. How far the disease has spread is worked out separately.Names on the report
Which related cells might my report mention?
Pathologists describe a small family of abnormal cells. The name used gives a clue to the type or subtype.
Classic Reed-Sternberg cell
Large, with two mirror-image nuclei or one nucleus with two lobes, each holding a prominent dark dot. This is the textbook finding.
Hodgkin cell
A version with a single nucleus. Reports often say "Hodgkin and Reed-Sternberg cells", shortened to HRS cells, to cover both.
Lacunar cell
The cell appears to sit in a small empty space, an effect of how the tissue is processed.
Points towards
- The nodular sclerosis subtype
Popcorn or LP cell
A cell with a folded, puffy nucleus. It is not a Reed-Sternberg cell and carries different markers.
Points towards
- Nodular lymphocyte-predominant Hodgkin lymphoma
Not sure whether this applies to you?
Ask an oncologistConfirming it
Is seeing the cell enough to make the diagnosis?
No. The look of the cell is the starting point, not the whole answer. Cells that resemble Reed-Sternberg cells can appear in some other lymphomas, and occasionally in reactions to infection such as glandular fever. The pathologist confirms the finding with marker stains.
The marker pattern that fits
In classical Hodgkin lymphoma the abnormal cells usually carry CD30 and CD15, and show weak or absent CD20 and CD45. They often show PAX5 weakly. This set of results, together with the background of normal immune cells, is what gives the diagnosis. Your report may list each marker as positive or negative.
Why a larger sample is preferred
Because the abnormal cells are so few, a fine needle sample can miss them or give too little to stain. Many haematologists ask for a whole lymph node to be removed, or a core of tissue taken with a wider needle. If your first sample was small and the report is uncertain, a repeat biopsy is not a failure. It protects you from treatment aimed at the wrong disease.
Reading it straight
What does the finding tell you, and what does it not?
It tells you
It does not tell you
The likely diagnosis is classical Hodgkin lymphoma
How far the disease has spread, which scans show
Which marker-based treatments may be relevant, such as drugs aimed at CD30
Which treatment you personally will be offered
A clue to the subtype, from the cell shapes seen
Your outlook, which depends on stage, symptoms, blood tests and response
That a haematologist should see you without delay
That anything must be decided today, before the full picture is in
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Commonly believed
What do families often misunderstand about this finding?
"Only a few abnormal cells were seen, so it is only a little cancer."
In Hodgkin lymphoma the abnormal cells are always a small minority of the node. Their number on the slide says nothing about the stage. Scans and blood tests answer that question.
"The biopsy cut into the gland, and that will spread the disease."
A biopsy does not spread lymphoma. Without tissue, nobody can name the disease or choose treatment. Delaying the biopsy only delays the diagnosis.
"Reed-Sternberg cells mean the family also carries this."
The change happens inside the cells of one person. Close relatives have a slightly higher chance of Hodgkin lymphoma, but the risk for any one relative stays low, and there is no routine screening test for them.
"The swelling went down with antibiotics, so the report must be wrong."
Glands in Hodgkin lymphoma can shrink and grow again on their own. If the report is uncertain, ask for a second review of the slides rather than setting it aside.
What happens next
What happens after the report is ready?
See a haematologist
Take the full report, including the marker results, to a haematologist or medical oncologist who treats lymphoma.
Staging tests
A PET-CT scan and blood tests show which areas are involved. The results give the stage and help set the length of treatment.
Tumour board review
At CION the case goes to a tumour board, a meeting of specialists, and the team coordinates any test not done in-house with a qualified centre.
A plan you understand
Ask what is recommended, who it does not suit, and what happens if the first scan during treatment is not clear.
Being straight with you
What can this page not tell you?
This page cannot read your report for you. Pathology wording is written for other doctors, and a single phrase such as "suggestive of" or "in the appropriate clinical setting" can change the meaning. Only someone who has your full report, your scans and your examination can put it together.
When to ask for a second review
Ask whether the slides can be reviewed by a lymphoma pathologist if the report says the cells are "Reed-Sternberg-like", if key markers were not tested, or if the findings do not fit how you are unwell. It is a normal request and does not delay care by much.
What the family can do this week
Collect every report in one folder: the biopsy, the marker results, any scans and recent blood tests. Write down when the swelling started, and any fevers, drenching night sweats, itching or weight loss. Bring that list to the first haematology visit. It saves time and helps the team stage the disease accurately.
Questions we are asked
Common questions about Reed-Sternberg cells
Do Reed-Sternberg cells always mean Hodgkin lymphoma?
Not always. Cells that look similar can appear in some non-Hodgkin lymphomas and, less often, in reactions to viral infections. That is why the pathologist adds marker stains. When the look of the cells, the markers and the background all fit, the diagnosis is classical Hodgkin lymphoma.
What does "HRS cells" mean on my report?
HRS stands for Hodgkin and Reed-Sternberg cells. It groups the classic two-nucleus cells with their single-nucleus version, called Hodgkin cells. Both are the abnormal cells of classical Hodgkin lymphoma, and pathologists usually describe them together.
My report says CD30 positive and CD15 positive. Is that bad?
It is not good or bad in itself. It is the pattern expected in classical Hodgkin lymphoma, so it supports the diagnosis. CD30 also matters for treatment, because some drugs target it. Your haematologist explains what the markers mean for your plan.
Can Reed-Sternberg cells be seen in a blood test?
No. They are found in tissue, usually a lymph node, not in an ordinary blood sample. Blood tests are still important. They check your blood counts, liver and kidneys, and inflammation, which help with staging and planning, but they cannot make this diagnosis.
Why was a second biopsy advised after the first one?
Usually because the first sample was too small, or showed some suspicious cells without enough tissue to test the markers. Hodgkin lymphoma has few abnormal cells, so this happens. A larger sample gives a clear answer and makes sure treatment is aimed at the right disease.
Does the number of Reed-Sternberg cells show how serious it is?
Not in a way that guides treatment for most people. The stage, symptoms such as fevers and night sweats, the size of any large mass, blood test results and the response to early treatment carry far more weight. A crowded slide does not mean a worse outlook.
Who are the cells named after?
They are named after Dorothy Reed and Carl Sternberg, two doctors who described them independently more than a century ago. Their descriptions still form the basis of how the disease is recognised under the microscope, though marker stains now make the diagnosis far more precise.
How soon should we see a specialist after this report?
Soon, ideally within days rather than weeks, but not in a panic. Book a haematology appointment and gather every report and scan you have. If there are fevers, trouble breathing or rapidly growing swelling in the neck or chest, seek medical care the same day.
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- National Cancer Institute — Definition of Reed-Sternberg cell - NCI Dictionary of Cancer Terms
- American Cancer Society — What Is Hodgkin Lymphoma?
- Cancer Research UK — Hodgkin lymphoma
- Leukemia & Lymphoma Society — Hodgkin Lymphoma
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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