HODGKIN LYMPHOMA

Classifications 1%

Hodgkin lymphoma 1% of all cancers Arises in lymph nodes –(tons., Wald., EXN rare) Spreads predictably characteristically to the anatomically contiguous nodes LN – spleen – liver – BM Staging: prognosis, choice of therapy

Patients Average: 32 years; slight male predominance (NS: M=F) Curable in many cases Lon-term survivors of chemo- and radiotherapy: Risk of developing second cancers MDS, AML, lung cancer, breast cancer

HODGKIN LYMPHOMA WHO 2008  CLASSICAL (95%)  NODULAR LYMPHOCYTE PREDOMINANT (nodular paragranuloma, 5%) DIFFER IN: TUMOUR CELLS BACKGROUND CLINICAL FEATURES

CLASSICAL HL FEATURES  COMMON TUMOUR CELLS  DIFFERENT BACKGROUND ARCHITECTURE CLINICAL, EPIDEMIOLOGY EBV SUBTYPES NODULAR SCLEROSIS MIXED CELLULARITY LYMPHOCYTE RICH LYMPHOCYTE DEPLETION

TUMOUR CELLS OF CLASSICAL HL Diagnostic only RS! Hodgkin cell eggs in the basket CD30+,CD15+ B-markers, EBV mummy lacunar

Classical HL NODULAR SCLEROSIS 70% CHL; 28 ys; M=F stage II, mediastinum 40% B-symptoms MIXED CELLULARITY grade I and II 20% CHL; 37 ys; 70% M stage III-IV peripheral lymph nodes spleen, bone marrow B-sympt., EBV common HIV

LYMPHOCYTE RICH LYMPHOCYTE DEPLETION Classical HL 5% CHL; older; 70% M stage I-II peripheral lymph nodes B-sympt. rare, but relapses <5% CHL; 37ys; 75% M advanced B-symptoms common poor, HIV (EBV)

Nodular lymphocyte predominance HL Nodular/diffuse pattern L&H; LP = popcorn cells Background FDC meshworks nonneoplastic lymphocytes Very favourable prognosis CD20

Reed-Sternberg cell: communication with other cell types

Hodgkin lymphoma – Ann Arbor staging I, II above diaphragm below III, IV Pruritus, anorexia; B sympt. correlate with stage