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Hodgkin's lymphoma: the pathologist's viewpoint
  1. S A Pileri1,
  2. S Ascani1,
  3. L Leoncini2,
  4. E Sabattini1,
  5. P L Zinzani1,
  6. P P Piccaluga1,
  7. A Pileri, Jr1,
  8. M Giunti1,
  9. B Falini3,
  10. G B Bolis4,
  11. H Stein5
  1. 1Pathologic Anatomy and Haematopathology, Bologna University, 40138 Bologna Italy
  2. 2Institute of Pathologic Anatomy and Histopathology, Siena University, 53100 Siena, Italy
  3. 3Institute of Haematology, Perugia University, 06100 Perugia, Italy
  4. 4Institute of Pathologic Anatomy, Perugia University in Terni, 05100 Terni, Italy
  5. 5Institute of Pathology, Berlin Free University, 12200 Berlin, Germany
  1. Correspondence to:
 Professor S A Pileri, Anatomia Patologica ed Ematopatologia, Istituto di Ematologia ed Oncologia Medica “L. e A. Seràgnoli”, Università di Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy;
 pileri{at}almadns.unibo.it

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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