Hodgkin's disease (HD)
- Hodgkin's lymphoma is a malignant proliferation of lymphocytes characterised by the presence of the Reed-Sternberg cell.
- Bimodal age distribution, most common in the third and seventh decades.
Histological classification
| Type |
Frequency |
Prognosis |
Notes |
| Nodular sclerosing |
Most common (around 70%) |
Good prognosis |
More common in women. Associated with lacunar cells |
| Mixed cellularity |
Around 20% |
Good prognosis |
Associated with a large number of Reed-Sternberg cells |
| Lymphocyte predominant |
Around 5% |
Best prognosis |
|
| Lymphocyte depleted |
Rare |
Worst prognosis |
|
'B' symptoms also imply a poor prognosis:
- weight loss > 10% in last 6 months
- fever > 38ºC
- night sweats
Staging
- PET/CT is the mainstay of imaging for staging Hodgkin's lymphoma.
Ann-Arbor staging
- I: single lymph node
- II: 2 or more lymph nodes/regions on the same side of the diaphragm
- III: nodes on both sides of the diaphragm
- IV: spread beyond lymph nodes
Each stage may be subdivided into A or B:
- A: no systemic symptoms other than pruritus
- B: weight loss > 10% in last 6 months, fever > 38°C, night sweats