Introduction

Cancer starts when any cell divides uncontrollably. All cells in the body can turn into cancer and spread to many different parts of the body. Lymphomas are cancers that occur in lymphocytes. There are two types of lymphoma:

  • Hodgkin Lymphoma (HL)
  • Non-Hodgkin Lymphoma (NHL)

In this article, some brief information will be explained about Hodgkin’s lymphoma. To understand Hodgkin Lymphoma more clearly, it is necessary to know some information about the lymph system. The lymph system is part of the immune system. It controls the flow of fluids in the body and also fights infections, bacteria, some other diseases, etc. The lymph system is made up of lymphocytes (a type of white blood cell). There are two types of lymphocytes:

  • T Lymphocytes (T Cells): T cells destroy abnormal or germ-like cells in the body. [1]
  • B Lymphocytes (B Cells): B cells produce proteins called antibodies to protect them from bacteria and viruses. [1]

Where Does Hodgkin’s Lymphoma Begin and How Does It Spread?

As you can see in the photo below, there is lymphatic tissue in many parts of the body. Hodgkin’s lymphoma usually starts in the B lymphocytes and the most common sites are under the neck, chest, or arms. [2]

Figure 1

Figure 1

It most often spreads from the lymph node to the lymph node through the lymph vessel. In the most recent stages of the disease, it can invade the bloodstream and spread to other parts of the body, such as the liver, lungs, bone marrow.

Types of Hodgkin Lymphoma

There are two types of Hodgkin Lymphoma: Classical Hodgkin Lymphoma (cHL) and Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL). [3]

Classic Hodgkin Lymphoma

The cancer cells in classical Hodgkin lymphoma are called Reed-Sternberg cells. These cells are abnormal types of B lymphocytes. People with classic Hodgkin lymphoma have a small number of Reed-Sternberg cells with a large number of immune cells around them. This situation causes swelling of the lymph nodes. [3]

Classic Hodgkin lymphoma has 4 subtypes: nodular sclerosis Hodgkin lymphoma, mixed cell Hodgkin lymphoma, lymphocyte-rich Hodgkin lymphoma, lymphocyte-poor Hodgkin lymphoma [3].

Figure 2

Figure 2

Nodular Lymphocyte-Predominant Hodgkin Lymphoma

The cancer cells in NLPHL are very large cells called popcorn cells (because they look like popcorn) and are variants of Reed-Sternberg cells. These cells are also called lymphocytic and histiocytic (L&H) cells. [3] Nodular lymphocyte-predominant Hodgkin lymphoma usually begins in the lymph nodes under the arms and neck. It can occur in people of any age and is more common in men than in women. This form of Hodgkin lymphoma tends to grow more slowly. [3]

Figure 3

Figure 3

Treatment of Hodgkin Lymphoma

Treatment of Hodgkin lymphoma is 80% likely to be successful if diagnosed early, and the treatment method is not difficult. HL, which is noticed late, is quite challenging and severe to treat. Some methods of treatment of HF include; Radiation, chemotherapy, targeted therapy, immunotherapy (including monoclonal antibodies), immune checkpoint inhibitors, chimeric antigen receptor (CAR) T-cell therapy, monoclonal antibodies. [4] As with any disease, early detection is very important in Hodgkin’s lymphoma disease. With modern medical technology, almost anything is possible. If you have pain in the areas where the lymphatic tissue is located in the picture in this article, be sure to see your doctor. Remember: ignorance will kill you, not the disease.

References:

  1. Bartlett NL, Foyil KV. Chapter 105: Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.
  2. National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hodgkin Lymphoma, Version I.2018 — December 20, 2017. Accessed at www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf on March 14, 2018.
  3. Younes A, Carbone A, Johnson P, Dabaja B, Ansell S, Kuruvilla J. Chapter 102: Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Classic Lymphoma Types. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
  4. Regacini R, Puchnick A, Luisi FAV, Lederman HM. Can diffusion-weighted whole-body MRI replace contrast-enhanced CT for initial staging of Hodgkin lymphoma in children and adolescents? Pediatr Radiol. 2018 Jan 23. 

Figure References:

  1. https://www.cancer.org/content/dam/cancer-org/images/illustrations/medical-illustrations/en/lymphatics.gif/jcr:content/renditions/cq5dam.thumbnail.350.350.jpeg
  2. https://www.verywellhealth.com/thmb/b9H_VUKE1TsI6iFGO5_Dt6efPAA=/4848×2727/smart/filters:no_upscale()/hodgkin-lymphoma-under-microscope-5b8581c4c9e77c0050da063f.jpg
  3. https://www.researchgate.net/profile/Nayef-Aqel/publication/255734136/figure/fig1/AS:267606049423371@1440813662229/Upper-three-images-of-popcorn-cells-demonstrating-their-complex-nuclear-features-The.png

Inspector: Furkan EKER

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