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Hodgkin lymphoma

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Hodgkin lymphoma (HL) is a type of cancer that affects the lymphatic system. It specifically targets a subgroup of white blood cells known as lymphocytes.

Hodgkin Lymphoma CT2
Hodgkin Lymphoma CT2

Lymphocytes are essential parts of the immune system that help the body fight infections. When this cancer is present, the lymph nodes often become enlarged. This condition is defined by the presence of unique, large cells called Reed–Sternberg cells. These cells are the primary indicator used by doctors to identify the disease.

Reed-Sternberg lymphocyte nci-vol-7172-300
Reed-Sternberg lymphocyte nci-vol-7172-300

The mechanism of Hodgkin lymphoma involves the abnormal growth of these Reed–Sternberg cells. These cells are often multinucleated, meaning they have more than one nucleus.

Hodgkin lymphoma (1) mixed cellulary type
Hodgkin lymphoma (1) mixed cellulary type

As they grow, they reside within the lymph nodes and attract other immune cells. This creates a reactive cell infiltrate made of lymphocytes, eosinophils, and plasma cells. This process can cause the lymph nodes to swell and feel rubbery. In some rare cases, people may feel pain in these nodes after consuming alcohol. This specific symptom occurs in only two to three percent of patients.

There are two major types of Hodgkin lymphoma. The first is classical Hodgkin lymphoma, which accounts for about 90% of cases. The second is nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), which makes up about 10%. NLPHL is distinct because it features special cells called "popcorn cells."

Popcorn cell in nodular lymphocyte predominant Hodgkin lymphoma - very high mag cropped
Popcorn cell in nodular lymphocyte predominant Hodgkin lymphoma - very high mag cropped

Classical Hodgkin lymphoma can be further divided into four specific subtypes. These include nodular sclerosing, mixed-cellularity, lymphocyte-rich, and lymphocyte-depleted subtypes. Each subtype is categorized by the appearance of the cells and the presence of certain proteins.

Medical history shows that the condition is named after Thomas Hodgkin. He was an English physician who first described the disease in 1832.

Hodgkin's Disease (Essentials of Medicine)
Hodgkin's Disease (Essentials of Medicine)

Since his discovery, scientists have identified many different factors related to the disease. For example, about half of all cases are linked to the Epstein–Barr virus (EBV). This virus is often found within the Reed–Sternberg cells themselves. Other risk factors include having HIV/AIDS or a family history of the condition.

The significance of Hodgkin lymphoma is reflected in its global impact and survival rates. In 2015, approximately 574,000 people worldwide had the disease. Of those people, 23,900, or 4.2%, died from it. In the United States, about 0.2% of the population will be affected at some point. Most diagnoses occur in people between the ages of 20 and 34. Fortunately, the survival rate in the United States is 89% for five years or longer. For people under the age of 20, the survival rate is even higher at 97%.

Doctors use several methods to diagnose and stage the disease. A definitive diagnosis requires a lymph node biopsy, where a small piece of tissue is examined under a microscope. Doctors also use Positron emission tomography (PET) scans to find small deposits of cancer. A PET scan uses radiolabeled glucose to make high-metabolism tissues light up on the image. Staging is done using the Ann Arbor classification system to see how much the cancer has spread. This helps doctors determine if the cancer is in one region or has spread to both sides of the diaphragm.

Treatment options depend on how advanced the cancer has become. Common treatments include chemotherapy, radiation therapy, and stem-cell transplantation. While these treatments can lead to a cure, they can also have long-term effects. Radiation and certain chemotherapy drugs may increase the risk of heart, lung, or other cancers later in life. Understanding the specific subtype and stage of the lymphoma is vital for choosing the best path forward.

Lymphomas, multiple myeloma world map - Death - WHO2004
Lymphomas, multiple myeloma world map - Death - WHO2004
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🖼️ Images & Media (6)
File:Hodgkin lymphoma (1) mixed cellulary type.jpg
Hodgkin lymphoma (1) mixed cellulary type.jpg
File:Hodgkin Lymphoma CT2.jpg
Hodgkin Lymphoma CT2.jpg
File:Reed-Sternberg lymphocyte nci-vol-7172-300.jpg
Reed-Sternberg lymphocyte nci-vol-7172-300.jpg
File:Popcorn cell in nodular lymphocyte predominant Hodgkin lymphoma - very high mag cropped.jpg
Popcorn cell in nodular lymphocyte...
File:Lymphomas, multiple myeloma world map - Death - WHO2004.svg
Lymphomas, multiple myeloma world map -...
File:Hodgkin's Disease (Essentials of Medicine).jpg
Hodgkin's Disease (Essentials of Medicine).jpg
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