Hodgkin Lymphoma

Question 1

What are lymphoid neoplasms that involve the bone marrow and peripheral blood called?

Answer 1

Lymphoid neoplasms that present with widespread involvement of the bone marrow and usually the peripheral blood are called lymphoid neoplasms.

Question 2

What are lymphoid proliferations that present as discrete tissue masses called?

Answer 2

Lymphoid proliferations presenting as discrete tissue masses are called lymphoma.

Question 3

How are lymphomas divided?

Answer 3

Lymphomas are divided into Hodgkin lymphoma (HL) and non-Hodgkin lymphomas (NHLs).

Question 4

What is required for the diagnosis of lymphoid neoplasia?

Answer 4

Histologic examination of lymph nodes or other involved tissues is required for the diagnosis of lymphoid neoplasia.

Question 5

What precedes the transformation of lymphoid cells?

Answer 5

Antigen receptor gene rearrangement generally precedes the transformation of lymphoid cells.

Question 6

What do malignant progenitor cells share?

Answer 6

Malignant progenitor cells share the same antigen receptor gene configuration and sequence and synthesize identical antigen receptor proteins (either Igs or T-cell receptors).

Question 7

What abnormalities are often associated with lymphoid neoplasms?

Answer 7

Lymphoid neoplasms are often associated with immune abnormalities.

Question 8

Who identified the abnormal cell in Hodgkin lymphoma

Answer 8

and who distinguished it from granulomas?

Question 9

How does Hodgkin lymphoma differ from NHLs in terms of spread?

Answer 9

Hodgkin lymphoma arises in a single node or chain of nodes and spreads first to anatomically contiguous lymphoid tissues, whereas NHLs often occur at extranodal sites and spread unpredictably.

Question 10

What is the distinctive morphological feature of Hodgkin lymphoma?

Answer 10

The distinctive morphological feature is the presence of Reed-Sternberg (RS) cells.

Question 11

What induces the accumulation of reactive lymphocytes

Answer 11

macrophages

Question 12

What are the Reed-Sternberg cells derived from?

Answer 12

Reed-Sternberg cells are derived from germinal center or post-germinal center B cells.

Question 13

What are the five subtypes of Hodgkin lymphoma recognized by WHO?

Answer 13

The subtypes are: Nodular sclerosis, Mixed cellularity, Lymphocyte-rich, Lymphocyte depletion, and Nodular lymphocyte predominance.

Question 14

What is the role of the Epstein-Barr virus in Hodgkin lymphoma?

Answer 14

The Epstein-Barr virus genome has been detected in approximately 50% of cases, but its exact role in the pathogenesis is unclear.

Question 15

What are the common clinical features of classical Hodgkin lymphoma (cHL)?

Answer 15

Common features include painless, asymmetrical lymph node enlargement, mediastinal involvement, splenic involvement, and other organ involvement in advanced disease.

Question 16

What hematological findings are common in Hodgkin lymphoma?

Answer 16

Normochromic normocytic anemia, neutrophilia, eosinophilia, lymphopenia, and elevated ESR and CRP are common findings.

Question 17

What is essential for diagnosing Hodgkin lymphoma?

Answer 17

Identification of Reed-Sternberg cells and their variants through histological examination is essential.

Question 18

What are the characteristics of lacunar Reed-Sternberg cells?

Answer 18

Lacunar cells have more delicate, folded, or multilobate nuclei with abundant pale cytoplasm, often appearing as if the nucleus is sitting in a lacuna.

Question 19

What defines nodular sclerosis Hodgkin lymphoma?

Answer 19

It is characterized by lacunar Reed-Sternberg cells and collagen bands dividing lymph nodes into nodules.

Question 20

What is the most common subtype of classical Hodgkin lymphoma?

Answer 20

The nodular sclerosis type is the most common subtype, accounting for 70% of cases.

Question 21

What differentiates mixed cellularity Hodgkin lymphoma?

Answer 21

It contains HRS cells in a mixed inflammatory background without nodular fibrosis and accounts for 25% of cases.

Question 22

What is the rarest subtype of classical Hodgkin lymphoma?

Answer 22

Lymphocyte-depleted Hodgkin lymphoma is the rarest subtype, accounting for less than 1% of cases.

Question 23

What is the typical appearance of “popcorn” cells in nodular lymphocyte-predominant Hodgkin lymphoma?

Answer 23

Popcorn cells are large pale-staining lymphohistiocytic cells surrounded by mature lymphocytes.

Question 24

How are Hodgkin lymphoma stages classified?

Answer 24

Stage I: Single lymph node area, Stage II: Two or more areas on one side of the diaphragm, Stage III: Nodes on both sides of the diaphragm, Stage IV: Diffuse or disseminated disease in extranodal sites.