Lymphomas 1: Hodgkin's Lymphomas

What are lymphomas?

Lymphomas are a neoplasm of the lymphoreticular organs. They present as solid nodular tumours usually in the lymph nodes, but sometimes in organs. Lymphoma malignant cells are not detectable in blood, so a biopsy is required for diagnosis.

Hodgkin's Lymphomas

Hodgkin's lymphomas make up a very small portion of all cancers, and only a slightly larger portion of all the lymphomas. They are very uncommon in children aged under 10, but are a young adults' disease, peaking at 20 years of age. However, after the age of 50, incidence increases.

Potential cause: Epstein-Barr virus (glandular fever), carcinogen exposure and immunodeficient people

Cure rate: 80%

Characteristics: arises in a single lymph node and spreads to adjacent nodes, cervical lymphadenopathy most common, involves malignant variants of B lymphocytes called Reed-Sternberg cells with large and prominent nucleoli, painless non-tender progressive enlargement of lymph nodes (commonly supra-clavicular nodes), spread to retroperitoneal lymph nodes, liver, spleen and bone marrow after a while, leukopenia

Symptoms: fever, night sweats, weight loss, splenomegaly, hepatomegaly, decreased infection defence

Diagnosis: biopsy

Treatment: chemotherapy and radiation therapy

Types of Hodgkin's Lymphomas

  1.   Nodular Sclerosis
  • Most common of the Hodgkin's lymphomas (adolescents and adults under 50)
  • Least aggressive
  • Variance (e.g. mutation) in B-lymphocytes, making them Reed-Sternberg cells, and lacunar cells → commonly due to Epstein-Barr virus
  • Diseased cells crowd lymph nodes and cause their enlargement
  • Lymph node sites: neck, upper chest and mediastinal lymph nodes
  2.   Mixed Cellularity
  • Second most common of the Hodgkin's lymphomas
  • Involves RS variants, as in nodular sclerosis, as well as eosinophils, neutrophils and lymphocytes
  • Affects older adults
  3.   Lymphocyte Predominance
  • Not common

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