Hodgkin Lymphoma

Figure 17: Hodgkin Lymphoma

Hodgkin lymphoma is a cancer of the immune system that is discernible by the presence of Reed-Sternberg cell. These cells are “bi-“ or “multi-nucleated” tumor cells that have very large nucleoli, resembling viral inclusion bodies.

These cells produce a number of lymphokines (Example: IL-5) which attract other non-neoplastic lymphocytes, histiocytes, fibroblasts and often eosinophils into the affected node.

This results in the very characteristic pathologic image of a lymph node with large amounts of collagenous fibrous tissue (from the fibroblasts), numerous small lymphocytes, histiocytes and eosinophils along with relatively few tumor cells.

Figure 18: Reed-Sternberg cell

Hodgkin’s lymphoma usually affects young people in their teens, 20’s and early 30’s, with a minor “bimodal” blip at around age 60.

There are two major types of Hodgkin lymphomas:

• Classical Hodgkin lymphoma
• Nodular lymphocyte-predominant Hodgkin lymphoma

Signs and Symptoms:

•  Painless enlargement of lymph nodes or spleen
• Fever for no reason
• Weight loss for unknown reason.
• Fatigue
• Drenching night sweats

Histology:

Hodgkin’s disease is divided by the Rye classification into four types:

• Lymphocyte predominant:

Lymphocyte predominant is thought to be a clinically distinct B cell lymphoma. This type of Hodgkin disease only affects a single lymph node.

Figure 19: Lymphocyte predominant

• Nodular sclerosis (most common) :

Nodular Sclerosis accounts for 70-80% of Hodgkin’s disease. It is typically a disease of young women which presents with cervical and mediastinal lymphadenopathy.

Figure 20: Nodular sclerosis

• Mixed cellularity:

Mixed cellularity is common in elderly people, and it often widespread at presentation.

Figure 21: Mixed cellularity

• Lymphocyte depleted:

Lymphocyte depleted is a very rare disease very rare and it exists is controversial.

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