Hodgkin Lymphoma

Question 1

What types of cells do you see in Hodgkin lymphoma?

Answer 1

“Owl’s eye” cells! = Reed Sternberg cells

-Malignant cells in Hodgkin lymphoma are few and far between - cells in the background are NOT malignant

Question 2

What Lymphoma is better to have?

Answer 2

Hodgkin Lymphoma!

Question 3

What things MUST you know about Hodgkin lymphoma?

Answer 3

• Younger patients, good prognosis
• Contiguous spread (stars in one place and follows linearly to another - along tissue planes or in local blood areas)
• Five subtypes (don’t matter for prognosis!)
• Reed-Sternberg cell
• Peaks in 20s and Later 50s

Question 4

What does a lymph node look like in Hodgkin lymphoma?

Answer 4

• Has fish-flesh, like non-hodgkin

- Not SUPER firm like metastatic cancer would be

Question 5

What does the liver and spleen look like in Hodgkin lymphoma?

Answer 5

• Have larger nodules (may be as little as one or two great big ones!)
• Otherwise, red and fleshy

Question 6

What cell MUST you remember for Hodgkin lymphoma??

Answer 6

REED-STERNBERG CELL = owls eye

-Two nucleoli - almost as big as the lymphocyte next to it!

Question 7

What can hodgkin malignant cells look like?

Answer 7

-Can be Reed Sternberg variants, can’t have more than two nuclei and odd shapes

Question 8

What is a tumor made up of in Hodgkin lymphoma?

Answer 8

• Reed sternberg cells are the malignant cells and all other cells are benign cells making up the bulk of the tumor
• Reed sternberg cells send out cytokine and call in the rest of the cells to the tumor area
• Background cells are a mixture!

Question 9

What are the Hodgkin Lymphoma subtypes?

Answer 9

1. Nodular Lymphocyte-predominance Hodgkin lymphoma
2. Classical Hodgkin Lymphoma
   a. Nodular sclerosis
   b. Lymphocyte rich
   c. Mixed cellularity
   d. Lymphocyte depletion

Question 10

What is Nodular L-P (lymphocyte-predominance) hodgkin lymphoma?

Answer 10

• Asymptomatic young male with cervical lymphadenopathy
• Good prognosis (early stage)
• B-cell origin
• Popcorn cells (reed sternberg in popcorn shape - background is all lymphocytes)

Question 11

What is Nodular Sclerosis Hodgkin Lymphoma?

Answer 11

• Most common subtype
• Good prognosis (early stage)
• Lacunar cells = variant of Reed Sternberg cells - look like they’re sitting in a little space/gap

Question 12

What is Mixed Cellularity Hodgkin Lymphoma?

Answer 12

• Worse prognosis
• Usually disseminated at presentation
• Classic Reed-Sternberg cells
• Mixture of background cells (eosinophils, histiocytes)

Question 13

What is Lymphocyte-Rich Hodgkin Lymphoma?

Answer 13

• Uncommon
• Usually localized at presentation
• Popcorn cells (less white space around it)

Question 14

What is Lymphocyte Depletion Hodgkin Lymphoma?

Answer 14

• Rare
• Often disseminated at presentation
• Classic Reed-Sternberg cells
• Collagen or reticulin background
• Rare lymphocytes

Question 15

What is the treatment and prognosis of Hodgkin Lymphoma?

Answer 15

• Surgery, chemo, radiation
• Prognosis depends on stage
• Danger: second malignancies