Hodgkin's lymphoma pathophysiology

Revision as of 15:55, 24 September 2015 by Sowminya Arikapudi (talk | contribs)
Jump to navigation Jump to search

Hodgkin's lymphoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hodgkin's lymphoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray Findings

CT

MRI

Ultrasound

Biopsy

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hodgkin's lymphoma pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hodgkin's lymphoma pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hodgkin's lymphoma pathophysiology

CDC on Hodgkin's lymphoma pathophysiology

Hodgkin's lymphoma pathophysiology in the news

Blogs on Hodgkin's lymphoma pathophysiology

Directions to Hospitals Treating Hodgkin's lymphoma

Risk calculators and risk factors for Hodgkin's lymphoma pathophysiology

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

Overview

On gross pathology, white-grey, uniform, and enlarged lymph nodes are characteristic findings of Hodgkin's lymphoma. On microscopic histopathological analysis, Reed-Sternberg cells, reactive cell infiltrate, and complete or partial effacement of the lymph node architecture are characteristic findings of Hodgkin's lymphoma.

Pathophysiology

Hodgkin's lymphoma, is a type of lymphoma, in which cancer originates from a specific type of white blood cells called lymphocytes.[1][2]

Associated Conditions

Reports from countries like Honduras,[3] China,[4] Mexico,[5] Peru,[6] and Malaysia[7] suggest an association between EBV infection and Hodgkin's lymphoma, an association that is more evident in the pediatric population[8] and in the subtype of mixed cellularity.[9]

Gross Pathology

On gross pathology, affected lymph nodes (most often, latero cervical lymph nodes) are enlarged, but their shape is preserved because the capsule is not invaded. Usually, the cut surface is white-grey and uniform. In some histological subtypes (e.g. nodular sclerosis), the cut surface may have a nodular aspect.

Microscopic Pathology

Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual CD45-, CD30+, and CD15+/- immuno phenotype. In approximately 50% of cases, the Reed-Sternberg cells are infected by the Epstein-Barr virus.


Reed-Sternberg cells (RSC) (Classical and variants)
Type of cell Characteristics
Classic
Reed-Sternberg cells (RSC) Include large size (20–50 micro metres), abundant, amphophilic, finely granular/homogeneous cytoplasm; two mirror-image nuclei (owl eyes) each with an eosinophilic nucleolus and a thick nuclear membrane (chromatin is distributed close to the nuclear membrane).
Variants
Hodgkin cells (Atypical mononuclear Reed-Sternberg cell) Have the same characteristics as Reed-Sternberg cells (RSC), but is mono nucleated.
Lacunar Reed-Sternberg cells Have a single hyper lobulated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space ("lacunae").
Pleomorphic Reed-Sternberg cells Have multiple irregular nuclei.
"Popcorn" Reed-Sternberg cells (Lympho-histiocytic variant) Have a very lobulated nucleus and small nucleoli.
"Mummy" Reed-Sternberg cells Have a compact nucleus with no nucleolus and basophilic cytoplasm.

References

  1. Scientific Style and Format: The CBE Manual for Authors, Editors, and Publishers. Cambridge University Press. 1994. pp. 97–. ISBN 978-0-521-47154-1.
  2. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. (Dec 15, 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. OCLC 23245604.
  3. Ambinder RF, Browning PJ, Lorenzana I, Leventhal BG, Cosenza H, Mann RB; et al. (1993). "Epstein-Barr virus and childhood Hodgkin's disease in Honduras and the United States". Blood. 81 (2): 462–7. PMID 8380725.
  4. Zhou XG, Hamilton-Dutoit SJ, Yan QH, Pallesen G (1993). "The association between Epstein-Barr virus and Chinese Hodgkin's disease". Int J Cancer. 55 (3): 359–63. PMID 8397160.
  5. Zarate-Osorno A, Roman LN, Kingma DW, Meneses-Garcia A, Jaffe ES (1995). "Hodgkin's disease in Mexico. Prevalence of Epstein-Barr virus sequences and correlations with histologic subtype". Cancer. 75 (6): 1360–6. PMID 7882287.
  6. Chang KL, Albújar PF, Chen YY, Johnson RM, Weiss LM (1993). "High prevalence of Epstein-Barr virus in the Reed-Sternberg cells of Hodgkin's disease occurring in Peru". Blood. 81 (2): 496–501. PMID 8380728.
  7. Peh SC, Looi LM, Pallesen G (1997). "Epstein-Barr virus (EBV) and Hodgkin's disease in a multi-ethnic population in Malaysia". Histopathology. 30 (3): 227–33. PMID 9088951.
  8. Armstrong AA, Alexander FE, Paes RP, Morad NA, Gallagher A, Krajewski AS; et al. (1993). "Association of Epstein-Barr virus with pediatric Hodgkin's disease". Am J Pathol. 142 (6): 1683–8. PMC 1886981. PMID 8389527.
  9. Andriko JA, Aguilera NS, Nandedkar MA, Abbondanzo SL (1997). "Childhood Hodgkin's disease in the United States: an analysis of histologic subtypes and association with Epstein-Barr virus". Mod Pathol. 10 (4): 366–71. PMID 9110300.
  10. Image courtesy of Dr Yale Rosen Radiopaedia(original file ‘’here’’). Creative Commons BY-SA-NC


Template:WikiDoc Sources