Hodgkin's Lymphoma Classification

By Dr Ananya Mandal, MD

Hodgkin’s lymphoma is a form of cancer that affects the B-lymphocytes, therefore increasing a patient’s susceptibility to infection. The cancer is usually diagnosed based on examination of a lymph node biopsy. The tissue samples are examined under the microscope and checked for the presence of Reed-Sternberg cells, a typical feature of Hodgkin’s disease.

Classic Hodgkin’s lymphoma can be categorised into four different types according to the Reed-Sternberg cell morphology and the cell composition that occurs around the Reed-Sternberg cells. The subtypes are described below:

Nodular sclerosis subtype

Thisis the most commonly occurring subtype. Large tumor nodules display scattered Reed-Sternberg cells among reactive lymphocytes, plasmocytes and eosinophils. Collagen fibrosis is present to varying degrees.

Mixed-cellularity subtype

This subtype is common and features numerous classic Reed-Sternberg cells amongst lymphocytes, plasmocytes, histiocytes and eosinophils. Previous infection with Epstein Barr virus is commonly associated with this subtype. The mixed-cellularity subtype is sometimes confused with the early phase of the nodular sclerosis type.

Lymphocyte-rich subtype

This subtype is rare and shares similar features with a particular form of non-Hodgkin’s lymphoma. This subtype is associated with the most favorable prognosis.

Lymphocyte depleted subtype

This is a rare subtype characterized by an abundance of pleomorphic Reed-Sternberg cells and few reactive lymphocytes.

Unspecified type

According to the present classification, nodular lymphocyte predominant Hodgkin’s lymphoma, which expresses CD20, is not included as a type of classic Hodgkin’s lymphoma.

Reviewed by , BSc

Further Reading

Last Updated: Aug 19, 2014

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