Hodgkin lymphoma
Cancer of lymphocytes with Reed–Sternberg cells in lymph nodes.
Hodgkin lymphoma is a type of cancer that originates in the lymphatic system, specifically affecting a subset of white blood cells known as lymphocytes. Its hallmark is the presence of multinucleated Reed–Sternberg cells within the lymph nodes. The condition was first identified in 1832 by English physician Thomas Hodgkin.
Common symptoms include fever, night sweats, and weight loss—collectively referred to as B symptoms—along with fatigue and itchy skin. Painless swelling of lymph nodes often occurs in the neck, under the arms, or in the groin. Enlargement of the spleen is also frequent, while liver enlargement is less common. Some individuals experience back pain, and a small number report pain in affected nodes after drinking alcohol, a rare but distinctive sign. Cyclical fevers, known as Pel–Ebstein fever, may also appear, though their existence is debated. In some cases, the disease can lead to airway obstruction, fluid buildup around the lungs or heart, liver dysfunction, or bone marrow infiltration.
The two main types are classical Hodgkin lymphoma, which accounts for about 90% of cases, and nodular lymphocyte-predominant Hodgkin lymphoma, making up the remaining 10%. These types differ in their cell structure, appearance, molecular features, and clinical behavior. Classical Hodgkin lymphoma is further divided into four subtypes based on the shape of Reed–Sternberg cells and the surrounding cell environment. Epstein–Barr virus (EBV) is linked to about half of all Hodgkin lymphoma cases, most often in the classical form, and these are considered a type of EBV-associated lymphoproliferative disease. Other risk factors include a family history of the condition and HIV/AIDS.
Diagnosis requires a lymph node biopsy to confirm the presence of cancer and identify Reed–Sternberg cells. Blood tests assess organ function and readiness for chemotherapy. Imaging techniques like PET scans help detect small deposits not visible on CT scans, and gallium scans may be used as an alternative.
Treatment options include chemotherapy, radiation therapy, and stem-cell transplantation. The approach depends on the cancer’s stage and whether it has favorable features. Early detection often leads to a cure. In the United States, the five-year survival rate is 89% overall, rising to 97% for those under 20. However, radiation and certain chemotherapy drugs raise the long-term risk of other cancers, heart disease, and lung disease.
Globally, about 574,000 people had Hodgkin lymphoma in 2015, with 23,900 deaths (4.2%). In the U.S., 0.2% of people are affected at some point in their lives, and most diagnoses occur between ages 20 and 34.
- named_after
- Thomas Hodgkin
- field
- Oncology, Hematology
- known_for
- Presence of Reed–Sternberg cells; two major types: classical and nodular lymphocyte-predominant
Lore & Background
The condition is defined by the presence of multinucleated Reed–Sternberg cells in lymph node biopsies. About half of cases are linked to Epstein–Barr virus, and these are generally the classic form. Other risk factors include a family history of the condition and having HIV/AIDS. The two major types are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Classical Hodgkin lymphoma accounts for about 90% of cases and can be subclassified into four subtypes based on Reed–Sternberg cell morphology. Nodular lymphocyte-predominant Hodgkin lymphoma is characterized by popcorn cells that express CD20 and is often treated differently. Symptoms may include fever, night sweats, weight loss, and non-painful enlarged lymph nodes in the neck, under the arm, or in the groin. Diagnosis is confirmed by lymph node biopsy. Treatment options include chemotherapy, radiation therapy, and stem-cell transplantation, with early detection often leading to a cure.
Reader's Guide
The presence of Reed–Sternberg cells remains a defining diagnostic feature. The disease is notable for its bimodal age distribution, with most diagnoses occurring between ages 20 and 34. In the United States, five-year survival rates are 89% overall and 97% for those under 20, though treatment carries risks of secondary cancers, heart disease, or lung disease. The link to Epstein–Barr virus in about half of cases highlights an infectious etiology. Staging uses the Ann Arbor classification, and treatment choice depends on disease stage and favorable features. The condition's legacy includes advancing understanding of lymphoproliferative disorders and the role of viral oncogenesis.
Did You Know?
- About half of Hodgkin lymphoma cases are due to Epstein–Barr virus.
- In the United States, 89% of people diagnosed survive for five years or longer.
- Pain following alcohol consumption is a rare but pathognomonic sign of Hodgkin lymphoma.
Frequently Asked Questions
What are Hodgkin lymphoma's powers/role?
Its hallmark ability is generating distinctive multinucleated Reed–Sternberg cells that build up inside lymph nodes. This disrupts normal lymphocyte function and undermines the immune system's defensive capacity.
How does Hodgkin lymphoma's story end?
In the majority of cases the condition is manageable through chemotherapy, radiation, or targeted therapies, often resulting in long-term remission. Diagnosis and treatment fall under the specialties of oncology and hematology.
What are Hodgkin lymphoma's two major forms?
The condition divides into classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. These subtypes differ in their cellular makeup and clinical behavior, which in turn steers treatment strategy.
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