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The presence of what distinctive cell characterizes the heterogenous group of diseases known as Hodgkin Lymphomas?
Reed-Sternberg Cell
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Identify the abnormal cell seen in the center of the picture below:
Reed-Sternberg Cell
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This type of lymphoma tends to show an orderly, contiguous pattern of spread: from one lymph node to the next lymph node down the chain, then the next, etc. This type tends to involve central or axial lymph nodes most often; peripheral lymph node involvement is much less common. Mesenteric lymph nodes and Waldeyer's ring are seldom involved, and these tend to be primarily lymph node diseases.
Hodgkin Lymphomas
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This type of lymphomas tend to be widely disseminated diseases at diagnosis; they are usually present elsewhere. They often involve peripheral lymph nodes. Mesenteric nodes and Waldeyer's ring are often involved, and these tend to be primarily lymph node diseases.
Non-Hodgkin Lymphomas
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Which are more common, Hodgkin Lymphomas or Non-Hodgkin Lymphomas?
Non-Hodgkin Lymphomas
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There is a bimodal age distribution of Hodgkin Lymphomas in the US. When is the first peak? When is the second?
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Are Hodgkin Lymphomas more common in males or females?
Males
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What infection is believed to be involved in about half of the cases of Hodgkin Lymphoma?
EBV
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Hodgkin Lymphomas are believed to be derived from what cell type?
B-cells
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What are the two main classifications for Hodgkin Lymphomas per the WHO?
- Nodular Lymphocyte Predominant HL
- Classical HL
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What are the four subtypes of Classical Hodgkin Lymphoma per the WHO?
- Nodular Sclerosis HL
- Mixed Cellularity HL
- Lymphocyte-rich classical HL
- Lymphocyte-depleted classical HL
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This subtype of Hodgkin Lymphoma has a B-cell phenotype, which differs from the phenotype of all other variants of HL. It is a relatively uncommon variant, comprising only about 5% of all HL. There is a significantly higher incidence in males, and it typically occurs at a relatively young age. This type is characteristically localized (low stage) at presentation (stage I or II), and cervical, axillary, and inguinal lymph nodes are often involved.
It has an indolent course, with long survival. There may be a tendency for late relapse. And this may transform to large cell Non-Hodgkin Lymphoma.
Nodular Lymphocyte Predominant HL
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What is by far the most common subtype of HL?
Nodular Sclerosis Classical HL
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This subtype of Hodgkin Lymphoma has an equal incidence in male and female populations. It is predominantly in young people (peak ~28 years), and is rare in older populations. This type is usually localized, and is most often stage II. Cervical, supraclavicular, and mediastinal involvement is common. This has a relatively indolent course.
Nodular Sclerosis Classical HL
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What tends to be the staging of Nodular Sclerosis Classical HL? What lymph nodes are typically involved?
- Stage II
- Cervical, Supraclavicular, and Mediastinal
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What tends to be the staging of Nodular Lymphocyte Predominant HL? What lymph nodes are typically involved?
- Stage I or II
- Cervical, Axillary, or Inguinal
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What is the second my common subtype of Hodgkin Lymphoma?
Mixed Cellularity Classical HL
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This subtype of Hodgkin Lymphoma tends to occur in the older population, and has a higher incidence in males than females. This is more often diagnosed at an advanced stage (III-IV), with an intra-abdominal disease more common (mediastinal disease uncommon). Clinically, this is a more aggressive HL. This tends to have more frequent malignant cells.
Mixed Cellularity Classical HL
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What is the only subtype of Hodgkin Lymphoma that is more common in females than males (or equal incidence acutally)?
Nodular Sclerosis Classical HL
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This subtype of Hodgkin Lymphoma is uncommon, and has a predominance of lympocytes and other benign cells. It has a higher incidence in males, and a slightly older population (median age = 50). This is usually localized (stage I or II), and has an indolent course.
Lymphocyte-rich Classical HL
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This subtype of Hodgkin Lymphoma is uncommon, and typically affects older patients. The incidence is higher in males. This type is typically diagnosed at an advanced stage (stage III-IV), and has an aggressive course.
Lymphocyte-depleted Classical HL
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This tends to be the most aggressive variant of Hodgkin Lymphoma -- often disseminated at diagnosis, with a more aggressive course with shorter survival.
Lymphocyte-depleted Classical HL
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What is the Ann Arbor Staging System for Hodgkin Lymphoma?
- Stage I: single lymph node or group
- Stage II: more than one group, but same side of diaphragm
- Stage III: disease both sides of diaphragm
- Stage IV: extranodal (liver, bone marrow, or disseminated extranodal)
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What symptoms are linked to the Ann Arbor Staging System for Hodgkin Lymphoma?
- Unexplained Fever (greater than 38 C)
- Drenching Night Sweats
- Unexplained Weight Loss ( more than 10 lbs)
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The presence of systemic symptoms in Hodgkin Lymphoma has a significant adverse prognostic indication. In relation to this, what do the suffixes "A" and "B" mean in the Ann Arbor Staging System?
- A: systemic symptoms absent
- B: systemic symptoms present
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What two things are associated with a worse prognosis?
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What is the primary treatment for Hodgkin Lymphoma?
Combination Chemotherapy
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