Blood Disorders Hodgkin\'s Lymphoma Hodgkin\'s

Blood Disorders

Hodgkin's lymphoma

Hodgkin's lymphoma

Hodgkin's lymphoma is the cancerous proliferation of a patient's lymphoid cells. The presence of Reed-Sternberg cells is a necessary precondition of the diagnosis of Hodgkin's lymphoma, although R-S cells are identified with other disorders. "The primary diagnosis of Hodgkin's lymphoma from the histopathologic examination of a lymph node requires the identification of Reed-Sternberg cells in an appropriate, reactive cellular background. If a diagnosis of HD has been established on lymph node biopsy, the criteria for diagnosis of extranodal sites can be relaxed - requiring only mononuclear R-S cells and their variants in an appropriate background- not classic bilobed R-S cells" (Lymphoma: Hodgkin's lymphoma (Part 1), 2010, University of Virginia). This is one reason why identification of R-S cells at the lymph nodes is so critical during the early diagnostic stages and not at extranodal sites, where R-S cells may not be present.

Hodgkin's lymphoma is divided into two major groups, the first of which is nodular lymphocyte predominant Hodgkin's lymphoma. The second type is classical Hodgkin's lymphoma, subdivided into nodular sclerosis classical Hodgkin's lymphoma; mixed cellularity classical Hodgkin's lymphoma; lymphocyte-rich classical Hodgkin's lymphoma; and lymphocyte-depleted classical Hodgkin's lymphoma. Nodular sclerosis classical Hodgkin's lymphoma is mainly manifested in women and lymphocyte-depleted classical Hodgkin's lymphoma is mainly manifested in AIDS patients (Lymphoma: Hodgkin's lymphoma (Part 2), 2010, University of Virginia). With lymphocyte-depleted classical Hodgkin's there are many R-S cell variants and most patients are at Stage III or Stage IV when diagnosed making their prognosis poor (Hemopathology, 2010, University of Utah). These latter types would be seen as unlikely suspects for the patient Mr. H.D.'s illness.

Mixed cellularity classical Hodgkin's lymphoma is more common in men (Lymphoma: Hodgkin's lymphoma (Part 2) 2010, University of Virginia). Prognosis of this type is fair, as most patients are at stage III when diagnosed (Hemopathology, 2010, University of Utah) However, it is also more commonly found in older men. The lack of clear manifestation of a type of lymphoma might have been the reason for the earlier inaccurate diagnosis of pharyngitis in Mr. H.D., before a tissue sample was taken. However Hodgkin's lymphoma does 'peak' during early adulthood, and then in later adulthood, so the patient was within a likely threshold period for manifesting the illness.