Hodgkin lymphoma

Lore & Background

The condition is defined by the presence of multinucleated Reed–Sternberg cells in lymph node biopsies. About half of cases are linked to Epstein–Barr virus, and these are generally the classic form. Other risk factors include a family history of the condition and having HIV/AIDS. The two major types are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Classical Hodgkin lymphoma accounts for about 90% of cases and can be subclassified into four subtypes based on Reed–Sternberg cell morphology. Nodular lymphocyte-predominant Hodgkin lymphoma is characterized by popcorn cells that express CD20 and is often treated differently. Symptoms may include fever, night sweats, weight loss, and non-painful enlarged lymph nodes in the neck, under the arm, or in the groin. Diagnosis is confirmed by lymph node biopsy. Treatment options include chemotherapy, radiation therapy, and stem-cell transplantation, with early detection often leading to a cure.

Reader's Guide

The presence of Reed–Sternberg cells remains a defining diagnostic feature. The disease is notable for its bimodal age distribution, with most diagnoses occurring between ages 20 and 34. In the United States, five-year survival rates are 89% overall and 97% for those under 20, though treatment carries risks of secondary cancers, heart disease, or lung disease. The link to Epstein–Barr virus in about half of cases highlights an infectious etiology. Staging uses the Ann Arbor classification, and treatment choice depends on disease stage and favorable features. The condition's legacy includes advancing understanding of lymphoproliferative disorders and the role of viral oncogenesis.

Did You Know?

• About half of Hodgkin lymphoma cases are due to Epstein–Barr virus.
• In the United States, 89% of people diagnosed survive for five years or longer.
• Pain following alcohol consumption is a rare but pathognomonic sign of Hodgkin lymphoma.