Introduction to Hodgkin Lymphoma
Hodgkin lymphoma is a type of lymphoma, which is a cancer originating from lymphocytes, a kind of white blood cell. It is characterized by the presence of Reed-Sternberg cells, which are large, malignant cells that can be identified under a microscope. The disease can affect lymph nodes, spleen, liver, and bone marrow.
Histological Features
Histologically, Hodgkin lymphoma is identified by the presence of
Reed-Sternberg cells. These cells are typically large, with a bilobed nucleus that gives them an "owl-eye" appearance due to prominent nucleoli. They are often found in a mixed inflammatory background including lymphocytes, eosinophils, neutrophils, and histiocytes.
Types of Hodgkin Lymphoma
There are two main types of Hodgkin lymphoma:Diagnostic Techniques
The diagnosis of Hodgkin lymphoma typically involves a combination of physical examination, imaging studies, and
biopsy. In histological examination, immunohistochemistry is often used to identify specific markers. Reed-Sternberg cells in classical Hodgkin lymphoma are usually positive for CD15 and CD30, while negative for CD45. In contrast, L&H cells in NLPHL are positive for CD20 and CD45 but negative for CD15 and CD30.
Immunohistochemistry
Immunohistochemistry helps to differentiate Hodgkin lymphoma from other types of lymphomas and reactive lymphadenopathies. Specific markers like
CD30 and CD15 are crucial in identifying Reed-Sternberg cells. In addition, PAX5 is often weakly positive in these cells. The staining pattern and the presence of these markers help pathologists confirm the diagnosis.
Clinical Presentation and Symptoms
Patients with Hodgkin lymphoma often present with painless lymphadenopathy, which is swelling of the lymph nodes. Other symptoms may include fever, night sweats, and weight loss, commonly referred to as "B symptoms." Some patients may also experience itching and fatigue.Prognosis and Treatment
The prognosis for Hodgkin lymphoma has significantly improved with advances in treatment. The main treatment modalities include
chemotherapy and radiation therapy. The choice of treatment depends on the stage and type of Hodgkin lymphoma. Early-stage disease often has an excellent prognosis with high cure rates.
Conclusion
Hodgkin lymphoma is a unique type of lymphoma with distinct histological features, primarily the presence of Reed-Sternberg cells. The disease has several subtypes, each with specific diagnostic markers. Advances in histological techniques and treatment options have significantly improved patient outcomes, making early and accurate diagnosis crucial for effective management.
