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Explore the classification and clinical features of Hodgkin's Lymphoma, a group of lymphoid neoplasms characterized by the presence of Reed-Sternberg cells. Learn about the different subtypes, morphology, and prognosis of this common malignancy.
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Lymphomas Hodgkins Lymphoma
Lymphoid Neoplasms • Leukaemias • Lymphomas • Plasma cell tumors
Lymphomas • Lymphoid neoplasms which arise as discrete tissue masses Hodgkins • Lymphomas Nonhodgkins
Hodgkins Lymphoma • Group of lymphoid neoplasms which is characterised by the presence of - neoplastic giant cells -- Reid Sternberg cells - in the company of reactive lymphocytes, histiocytes, eosinophils, neutrophils , plasma cells • RS cells are derived from B cells
Morphology of RS cells • Classical • Variants * Mononuclear variant * Lacunar Cells * L & H variants ( Lymphohistiocytic )
Clinical Features • One of the most common forms of malignancy in young adults • Average age of 32 years • Constitutional symptoms include fever , night sweats , weight loss • Curable in most cases
Classification of HD ( WHO) • 1. Nodular Lymphocyte predominant HD • 2. Classical HD • - Nodular sclerosis • - Mixed Cellularity • - Lymphocyte Rich • - Lymphocyte depletion
HD - Nodular Sclerosis • 65 – 70% • Adolescents & young adults • Characterised by 1. Lacunar cells 2. Collagen bands • Lower cervical , supraclavicular , mediastinal lymph nodes of young adults • Prognosis is excellent
Mixed Cellularity • 20 – 25 % , Most common in patients> 50 years • Diffuse effacement by a mixed cellular infilterate – small lymphocytes , eosinophils, plasma cells , macrophages mixed with RS cells. • Diagnostic RS cells & mononuclear variants are plentiful • systemic symptoms , advanced tumor stage
Lymphocyte Rich Type • Uncommon • Reactive lymphocytes make majority of infilterate • Frequent mononuclear & diagnostic RS cells. • Associated with EBV in 40% • Excellent prognosis
Lymphocyte Depletion type • < 5% • Paucity of lymphocytes, abundance of RS cells • Older patients , HIV + ve • Often HBV associated • Outcome less favourable
Lymphocyte Predominant Type • Uncommon , 5% • Nodal effacement by nodular infilterate of small lymphocytes ,other reactive cells are rare • Typical RS cells rare . More common are L& H variants ( popcorn cells) • Isolated cervical /axillary lymphadenopathy • Excellent prognosis