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Questions and Answers
Hodgkin lymphoma is a type of non-cancerous growth in the lymphatic system.
False
Epstein-Barr virus infection does not seem to have any association with some subtypes of Hodgkin lymphoma.
False
Hodgkin's disease has only two peak incidences: childhood and young adults.
False
Fever, night sweats, and weight loss are more common in nodular lymphocyte predominant Hodgkin lymphoma than in classical Hodgkin lymphoma.
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The World Health Organization does not classify Hodgkin lymphoma into different types.
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Hodgkin and Reed-Sternberg cells usually express CD15 and CD30.
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In nodular sclerosis type of Hodgkin lymphoma, the growth pattern involves narrow fibroblast-rich collagen bands surrounding each nodule.
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Mixed cellularity type of Hodgkin lymphoma typically presents with a preserved lymph node architecture.
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Nodular lymphocyte predominant type of Hodgkin lymphoma usually presents with total replacement of nodal architecture by small lymphocytes and large tumor cells.
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Epstein-Barr virus (EBV) is commonly associated with the presence of prominent epithelioid histiocytes in Hodgkin lymphoma cases.
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Hodgkin lymphoma staging includes 5 stages based on the extent of lymph node involvement.
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In nodular sclerosis type of Hodgkin lymphoma, the presence of eosinophils, histiocytes, and neutrophils in the inflammatory background is common.
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Study Notes
Definition and Etiology
- Hodgkin lymphoma, also known as Hodgkin's disease, is a type of cancer of the lymphatic system.
- Epstein-Barr virus infection may play a significant role in the development of some subtypes, especially in pediatric patients from tropical or developing countries.
Epidemiology
- There are three peaks of incidence: childhood (0-14 years), young adult (15-34 years), and older adult Hodgkin's disease (55+ years).
Clinical Features
- Localized painless lymphadenopathy
- Fever, night sweats, and weight loss are more common in CHL than NLPHL
Types of Hodgkin Lymphoma
- Nodular sclerosing
- Mixed cellularity
- Lymphocyte depleted
- Lymphocyte rich
- Nodular lymphocyte predominant
Histologic Description
- Classic Hodgkin Lymphoma:
- Neoplastic cells are Hodgkin and Reed-Sternberg (HRS) cells which usually express CD15 and CD30
- Effaced lymph node with variable number of HRS cells in a background of inflammatory cells
- Types of Reed-Sternberg cells:
- Classic HRS cells: large, binucleate or bilobed nucleus, may have single/multiple multilobate nucleoli or large, inclusion-like, owl-eyed eosinophilic nucleoli
- Mononuclear RS variant: single round or oblong nucleus with large inclusion-like nucleoli
- "Mummified" cells: HRS cells with condensed cytoplasm and pyknotic reddish nuclei
- "Lacunar" cells: HRS cells surrounded by formalin retraction artifact, characteristic for nodular sclerosing subtype
- Popcorn cells: found in nodular lymphocyte predominant subtype
Subtypes of Hodgkin Lymphoma
- Nodular sclerosis:
- Nodular growth pattern with broad fibroblast-poor birefringent collagen bands surrounding at least one nodule
- Highly variable numbers of HRS cells, small lymphocytes, and other inflammatory cells
- Mixed cellularity:
- Effaced lymph node architecture; interfollicular pattern also possible
- May have interstitial fibrosis but no broad bands of sclerosis or capsular thickening
- Typical HRS cells in a variable inflammatory background
- Nodular lymphocyte predominant:
- Total replacement of nodal architecture by expansive vague nodules of small lymphocytes -Sparse, relatively large tumor cells with multilobulated or round nucleus, thin nuclear membrane, finely granular chromatin, and variable small nucleoli (popcorn cells)
Staging
- Stage I: A single lymph node area or single extranodal site
- Stage II: 2 or more lymph node areas on the same side of the diaphragm
- Stage III: Lymph node areas on both sides of the diaphragm
- Stage IV: Disseminated or multiple involvement of the extranodal organs
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Description
Learn about Hodgkin lymphoma, a type of cancer of the lymphatic system, including its causes, such as Epstein-Barr virus infection, and the different peak incidences in childhood and young adulthood.
