Hodgkin's lymphoma classification: Difference between revisions

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{{Hodgkin's lymphoma}}
{{Hodgkin's lymphoma}}
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{{CMG}}; {{AE}} {{AS}}
 
==Overview==
Hodgkins lymphoma may be classified into 5 subtypes based on Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen.
 
 
== Classification ==
== Classification ==
===Classical ===
Hodgkins lymphoma may be classified into 5 subtypes based on Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen.
Classical Hodgkin's lymphoma (excluding nodular lymphocyte predominant Hodgkin's) can be subclassified into 4 pathologic subtypes based upon Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen. ({{ICDO|9650|3}})
 
   
 
Classic Hodgkin's Lymphoma (CHL) subtypes:
# Nodular sclerosing CHL is the most common subtype and is composed of large [[tumor]] nodules with lacunar RS cells subtype composed of numerous classic often pleomorphic RS cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma. ({{ICD10|C|81|3|c|81}}, {{ICDO|9653|3}})
# Mixed-cellularity subtype is a common subtype and is composed of numerous classic RS cells admixed with numerous inflammatory cells including [[lymphocyte]]s, [[histiocyte]]s, [[eosinophil]]s, and [[plasma cell]]s. ({{ICD10|C|81|2|c|81}}, {{ICDO|9652|3}})
# Lymphocyte-rich and
# lymphocyte depleted are rare subtypes.


=== Other ===
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is no longer classified as a form of classic Hodgkin's lymphoma. This is due to the fact that the RSC variants (popcorn cells) that characterize this form of the disease invariably express B lymphocyte markers such as CD20 (thus making NLPHL an unusual form of B cell lymphoma), and that (unlike classic HL) NLPHL may progress to [[B-cell lymphoma|diffuse large B cell lymphoma]]. There are small but clear differences in prognosis between the various forms.
|+ '''Hodgkins lymphoma classification'''
! style="background: #4479BA;; color:#FFF;" | Name
! style="background: #4479BA;; color:#FFF;" | Description
|-
| style="padding: 5px 5px; background: #F5F5F5;" | Nodular sclerosing Hodgkins lymphoma
| style="padding: 5px 5px; background: #F5F5F5;" | Most common subtype and is composed of large [[tumor]] nodules showing scattered lacunar classical Reed–Sternberg cells set in a background of reactive [[lymphocytes]], [[eosinophils]], and [[plasma cells]] with varying degrees of collagen [[fibrosis]]/[[sclerosis]].
|-
| style="padding: 5px 5px; background: #F5F5F5;" | Mixed-cellularity subtype
| style="padding: 5px 5px; background: #F5F5F5;" | Common subtype and is composed of numerous classic Reed-Sternberg cells admixed with numerous inflammatory cells including lymphocytes, [[histiocytes]], eosinophils, and plasma cells without sclerosis. This type is most often associated with  [[Epstein–Barr virus]] (EBV) infection and may be confused with the early, so-called 'cellular' phase of nodular sclerosing classical Hodgkins lymphoma.
|-
| style="padding: 5px 5px; background: #F5F5F5;" | Lymphocyte-rich
| style="padding: 5px 5px; background: #F5F5F5;" | Rare subtype, show many features which may cause diagnostic confusion with nodular lymphocyte predominant B-cell [[Non-Hodgkin's Lymphoma]] (B-NHL). This form also has the most favorable prognosis.
|-
| style="padding: 5px 5px; background: #F5F5F5;" | Lymphocyte depleted
| style="padding: 5px 5px; background: #F5F5F5;" | Rare subtype, composed of large numbers of often pleomorphic Reed-Sternberg cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma. Many cases previously classified within this category would now be reclassified under anaplastic large cell lymphoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" | Unspecified
| style="padding: 5px 5px; background: #F5F5F5;" |
|}   


Lymphocyte predominant HL is an uncommon subtype composed of vague nodules of numerous reactive lymphocytes admixed with large popcorn-shaped RSC. Unlike classic RSC, the non-classic popcorn-shaped RS cells of NLPHL are CD15 and CD30 negative while positive for the B cell marker CD20. ({{ICD10|C|81|0|c|81}}, {{ICDO|9659|3}})


==References==
==References==

Revision as of 17:51, 4 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

Hodgkins lymphoma may be classified into 5 subtypes based on Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen.


Classification

Hodgkins lymphoma may be classified into 5 subtypes based on Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen.


Hodgkins lymphoma classification
Name Description
Nodular sclerosing Hodgkins lymphoma Most common subtype and is composed of large tumor nodules showing scattered lacunar classical Reed–Sternberg cells set in a background of reactive lymphocytes, eosinophils, and plasma cells with varying degrees of collagen fibrosis/sclerosis.
Mixed-cellularity subtype Common subtype and is composed of numerous classic Reed-Sternberg cells admixed with numerous inflammatory cells including lymphocytes, histiocytes, eosinophils, and plasma cells without sclerosis. This type is most often associated with Epstein–Barr virus (EBV) infection and may be confused with the early, so-called 'cellular' phase of nodular sclerosing classical Hodgkins lymphoma.
Lymphocyte-rich Rare subtype, show many features which may cause diagnostic confusion with nodular lymphocyte predominant B-cell Non-Hodgkin's Lymphoma (B-NHL). This form also has the most favorable prognosis.
Lymphocyte depleted Rare subtype, composed of large numbers of often pleomorphic Reed-Sternberg cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma. Many cases previously classified within this category would now be reclassified under anaplastic large cell lymphoma
Unspecified


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