Hodgkin Lymphoma

2021-02-22 12:00 AM

Hodgkin lymphoma has some characteristics that are different from non-Hodgkin lymphoma.

HODGKIN LYMPHOMA

Hodgkin lymphoma has some characteristics that are different from non-Hodgkin lymphoma.

  • May present similar to infection (with fever)
  • Spread is contiguous to adjacent node groups
  • No leukemic state
  • The extranodal spread is uncommon

The malignant cells are the diagnostic Reed-Sternberg cells; these malignant cells are intermixed with reactive inflammatory cells. The Reed-Sternberg cell is a large malignant tumour cell that has a bilobed nucleus with a prominent large inclusion-like nucleolus in each lobe.

Hodgkin lymphoma classification:

  •  Lymphocyte-rich type (rare): composed primarily of reactive lymphocytes; associated with Epstein-Barr virus (40% of cases)
  •  Lymphocyte-predominant type: has lymphohistiocytic variants (L&H cells, called“popcorn cells”) and a unique phenotype (CD45+, CD15-, CD30-, CD20+)
  •  Mixed cellularity type: occurs in middle-aged and older males; the increased number of eosinophils is related to IL-5 secretion
  •  Lymphocyte-depleted type: presents with abdominal adenopathy; Reed-Stern-berg cells predominate

 Nodular sclerosis type (most common subtype (65–70% of cases)): is the only type in which females >, males 

°°    Lymph node has broad collagen bands

°°    Reed-Sternberg cell has clear space in the cytoplasm (lacunar cell)

Hodgkin lymphoma has a bimodal age group distribution (age late 20s and >50).

Patients usually present with painless enlargement of lymph nodes.

Poor prognosis is directly proportional to the number of Reed-Sternberg cells pres-ent. Survivors of chemotherapy and radiotherapy have an increased risk for secondary non-Hodgkin lymphoma or acute leukaemia.