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Hodgkin’s lymphoma, also known as Hodgkin’s disease is a type of lymphoma (cancer originating from a type of white blood cells called lymphocytes). It was named after Thomas Hodgkin, who first described it in 1832.
Hodgkin’s lymphoma is characterized by the orderly spread of disease from one lymph node group to another, and by the development of systemic symptoms with advanced disease. The disease is characterized by the presence of Reed-Sternberg cells (RS cells) on microscopic examination. Hodgkin lymphoma was one of the first cancers which could be cured using radiation therapy and, later, it was one of the first to be cured by combination chemotherapy.
The disease occurrence shows two peaks: the first in young adulthood (age 15–35) and the second in those over 55 years old. The survival rate is generally 90% or higher when the disease is detected during early stages, making it one of the more curable forms of cancer.[1] Later-stage cancers, though, continue to show a significantly worse prognosis.[2] The full remission (cure) rate for stages I and II is about 90-95%, while in stages III and IV, the cure rate is about 80-90%. Thus, most patients treated for Hodgkin’s lymphoma can go on to live normal, long lives.
Classical Hodgkin’s lymphoma (excluding nodular lymphocyte predominant Hodgkin’s lymphoma) 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 (the cell composition around the Reed-Stenberg cell(s)).
Nodular lymphocyte predominant Hodgkin’s lymphoma expresses CD20, and is not currently considered a form of classical Hodgkin’s.
For the other forms, although the traditional B cell markers (such as CD20) are not expressed on all cells,[3] Reed-Sternberg cells are usually of B cell origin.[4][5] Although Hodgkin’s is now frequently grouped with other B cell malignancies, some T cell markers (such as CD2 and CD4) are occasionally expressed.[6] However, this may be an artifact of the ambiguity inherent in the diagnosis.
Hodgkin’s cells produce Interleukin-21 (IL-21), which was once thought to be exclusive to T cells. This feature may explain the behavior of classical Hodgkin’s lymphoma, including clusters of other immune cells gathered around HL cells (infiltrate) in cultures.[7]
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