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Questions and Answers
Hodgkin lymphoma is a type of non-cancerous growth in the lymphatic system.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
