Light micrograph of Hodgkin lymphoma, nodular sclerosis subtype. Some types of nodular sclerosis subtype show confluent sheets of pleomorphic neoplastic cells. Foci of necrosis may be present. These cases have been referred to as syncytial variant of nodular sclerosis Hodgkin lymphoma, which is included in the grade II category. When this feature is pronounced, they may be misdiagnosed as anaplastic large cell lymphoma, metastatic carcinoma, or even thymoma (if the tumor location is mediastinal).