Introduction:
Hodgkin’s lymphoma is grouped under a kind of blood cancer that affects the lymphatic system (a constituent of the immune system- that helps fight infections). These types of blood cancers start in the lymphocytes (white blood cells and a part of the lymphatic system). In many cases, signs and symptoms of Hodgkin’s lymphoma can be eliminated completely, and people respond well to the treatment.
What Is Hodgkin's Lymphoma?
A lymphoma is a kind of cancer that is seen to affect the lymphatic system. It is also known as Hodgkin’s disease. Lymphomas can be categorized into Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). The origination of Hodgkin’s and non-Hodgkin’s lymphoma takes place from different cells, behaves differently, and is treated differently. It is an inherited kind of disorder. This kind of cancer is hardly seen, and men are more susceptible to it.
What Are the Symptoms of Hodgkin's Lymphoma?
The symptoms of Hodgkin’s lymphoma are frequently painless, swollen lymph nodes seen in the neck, groin area, or underarms. Some of the usual symptoms are:
Persistent Fatigue: fatigue is a feeling of much more tiredness than usual for at least some days.
Unexplained Fever: A fever above 103 degrees Fahrenheit (39.5 degrees Celcius) for two or more hours or longer than two days might indicate a serious problem.
Drenching Night Sweats: This sweating is so intense that it drenches the sheets.
Weight loss: Losing body weight without trying to do it. Losing 10 percent of the total body weight over six months indicates weight loss.
Itchy skin: Some people with Hodgkin lymphoma experience itchiness in the skin after drinking alcohol or taking a bath.
Belly (abdominal) pain or swelling: All kinds of belly pain do not indicate serious illness.
Chest pain: Chest pain might be a symptom of Hodgkin lymphoma in the lung tissues or lymph nodes inside the chest cavity.
What Are Hodgkin's Lymphoma Variants and Subtypes?
Hodgkin’s lymphoma can be identified by examining the lymph nodes or other tissues to look for Reed-Sternberg cells. It can be categorized into two main subtypes which are:
-
Classical Hodgkin lymphoma- Classical Hodgkin lymphoma is characterized by the presence of two kinds of cells: Hodgkin and Reed-Sternberg. Most cases of Hodgkin’s lymphoma are of this type, estimated to be around 95 %. It can be categorized into four main subtypes which are:
-
Nodular Sclerosing Hodgkin Lymphoma: This is the most frequent subtype of classic Hodgkin lymphoma. It frequently affects young adults, females especially. This subtype of classical Hodgkin’s lymphoma is typically seen to affect lymph nodes in the center of the chest.
-
Mixed Cellularity Hodgkin Lymphoma: This subtype of classic Hodgkin lymphoma is seen to affect people at the age of around 60 frequently. It is sometimes seen to form in the abdomen of the people. People with this subtype have lymph nodes carrying various cell types, including most Reed-Sternberg cells.
-
Lymphocyte-Rich Classic Hodgkin Lymphoma: This subtype of Hodgkin lymphoma is seen to affect around six percent of people with Hodgkin lymphoma. It is more frequently seen in males than females. It is called lymphocyte-rich as the affected lymph nodes carry many normal lymphocytes accompanied by Reed-Sternberg cells.
-
Lymphocyte-Depleted Hodgkin Lymphoma: This subtype of Hodgkin lymphoma is seen to affect around one percent of people with Hodgkin lymphoma. It is most frequently seen in people aged 60 and older and also in people who have HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome). As the name suggests, the condition depletes or replaces normal cells in lymph nodes with unusual cells.
-
-
Nodular Lymphocyte-Predominant Hodgkin Lymphoma: The presence of lymphocyte-predominant cells characterizes nodular lymphocyte-predominant Hodgkin lymphoma, sometimes referred to as “popcorn cells,” which are a variant of Reed-Sternberg cells. This kind of lymphoma is seen to affect around five percent of people with Hodgkin’s lymphoma. It is more frequently reported in people who are in their 20s.
What Are the Diagnostic Challenges of Hodgkin's Lymphoma?
It is a belief that diagnosing Hodgkin’s lymphoma is much easier than non-Hodgkin’s lymphoma. Typically, an open lymph node biopsy is preferred to diagnose Hodgkin lymphoma. Patients and clinicians usually face challenges, beginning with the complexity of the initial diagnosis. Hodgkin’s lymphoma affects the lymphatic system, a constituent of the immune system that helps fight infections. It can often resemble an infection or inflammation only. Therefore, it is challenging to diagnose its symptoms. A proper review of biopsy by an experienced haemato-pathologist is highly advised because of the typical challenges in making a diagnosis. The diagnosis of Hodgkin’s lymphoma is based on the symptoms and its staging and is thoroughly discussed by a team of experienced doctors. The treatment protocol is decided after preparing a proper patient case report. In a report, to see the limitations of cytology in diagnosing HL, smears were taken with the help of fine-needle aspiration (FNA) of the suspected cases. Immunocytochemical and immunohistochemical studies were done on them. Amongst the histologically diagnosed HL cases, definitive cytodiagnosis of HL (initial and reviewed) was significantly less frequently observed than cytodiagnosis of NHL among histologically diagnosed NHL cases. It is advised that proper interpretation of cytologic features, together with the incorporation of immunocytochemical parameters, can help reduce the margin of error in the cytodiagnosis of HL.
Conclusion:
Hodgkin’s lymphoma is grouped under a kind of blood cancer that affects the lymphatic system (a constituent of the immune system- that helps fight infections). Hodgkin’s lymphoma can be categorized into two main subtypes: Classical Hodgkin lymphoma and Nodular lymphocyte-predominant Hodgkin lymphoma. The main challenge in diagnosing this lymphoma is that it can often resemble an infection or inflammation only.
