Article Text
Abstract
Despite its well known histological and clinical features, Hodgkin's lymphoma (HL) has recently been the object of intense research activity, leading to a better understanding of its phenotype, molecular characteristics, histogenesis, and possible mechanisms of lymphomagenesis. There is complete consensus on the B cell derivation of the tumour in most cases, and on the relevance of Epstein-Barr virus infection and defective cytokinesis in at least a proportion of patients. The REAL/WHO classification recognises a basic distinction between lymphocyte predominance HL (LP-HL) and classic HL (CHL), reflecting the differences in clinical presentation and behaviour, morphology, phenotype, and molecular features. CHL has been classified into four subtypes: lymphocyte rich, nodular sclerosing, with mixed cellularity, and lymphocyte depleted. The borders between CHL and anaplastic large cell lymphoma have become sharper, whereas those between LP-HL and T cell rich B cell lymphoma remain ill defined. Treatments adjusted to the pathobiological characteristics of the tumour in at risk patients have been proposed and are on the way to being applied.
- Hodgkin's lymphoma
- differential diagnosis
- subtypes
- Epstein-Barr virus
- ALCL, anaplastic large cell lymphoma
- ALCL-HL, ALCL Hodgkin-like type
- BNLI, British national lymphoma investigation
- CHL, common Hodgkin's lymphoma
- DLBCL, diffuse large B cell lymphoma
- EBER, Epstein-Barr virus early RNA
- EBV, Epstein-Barr virus
- EMA, epithelial membrane antigen
- FDC, follicular dendritic cell
- FL, follicular lymphoma
- HC, Hodgkin's cell
- HCRBCL, histiocyte rich large B cell lymphoma
- HD, Hodgkin's disease
- HIV, human immunodeficiency virus
- HL, Hodgkin's lymphoma
- H&RS, Hodgkin's and Reed-Sternberg
- IL, interleukin
- LD-CHL, lymphocyte depletion CHL
- L/H, lymphocytic/histiocytic
- LL, Lennert's lymphoma
- LMP, latent membrane protein
- LP-HL, lymphocyte predominant HL
- LR-CHL, lymphocyte rich CHL
- MC-CHL, mixed cellularity CHL
- NHL, non-Hodgkin's lymphoma
- NS-CHL, nodular sclerosis CHL
- PCNA, proliferating cell nuclear antigen
- PCR, polymerase chain reaction
- PMLBCL, primary mediastinal large B cell lymphoma
- PTGC, progressively transformed germinal centre
- REAL, revised European–American
- RS, Reed-Sternberg
- TCR, T cell receptor
- TCRBCL, T cell rich B cell lymphoma
- TNF, tumour necrosis factor
- WHO, World Health Organisation
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- ALCL, anaplastic large cell lymphoma
- ALCL-HL, ALCL Hodgkin-like type
- BNLI, British national lymphoma investigation
- CHL, common Hodgkin's lymphoma
- DLBCL, diffuse large B cell lymphoma
- EBER, Epstein-Barr virus early RNA
- EBV, Epstein-Barr virus
- EMA, epithelial membrane antigen
- FDC, follicular dendritic cell
- FL, follicular lymphoma
- HC, Hodgkin's cell
- HCRBCL, histiocyte rich large B cell lymphoma
- HD, Hodgkin's disease
- HIV, human immunodeficiency virus
- HL, Hodgkin's lymphoma
- H&RS, Hodgkin's and Reed-Sternberg
- IL, interleukin
- LD-CHL, lymphocyte depletion CHL
- L/H, lymphocytic/histiocytic
- LL, Lennert's lymphoma
- LMP, latent membrane protein
- LP-HL, lymphocyte predominant HL
- LR-CHL, lymphocyte rich CHL
- MC-CHL, mixed cellularity CHL
- NHL, non-Hodgkin's lymphoma
- NS-CHL, nodular sclerosis CHL
- PCNA, proliferating cell nuclear antigen
- PCR, polymerase chain reaction
- PMLBCL, primary mediastinal large B cell lymphoma
- PTGC, progressively transformed germinal centre
- REAL, revised European–American
- RS, Reed-Sternberg
- TCR, T cell receptor
- TCRBCL, T cell rich B cell lymphoma
- TNF, tumour necrosis factor
- WHO, World Health Organisation