Hodgkin's Disease - Introduction

Introduction

Hodgkin's disease is a type of lymphoma. Lymphomas are cancers of the lymphatic system. They are generally subdivided into two groups: Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). NHL is discussed in another report. [For more information, see In-Depth Report #84: Non-Hodgkin's lymphomas.] Hodgkin’s disease is also called Hodgkin’s lymphoma.

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Hodgkin’s disease is marked by the presence of abnormal large cells called Reed-Sternberg cells. Reed-Sternberg cells are derived from B cell lymphocytes (white blood cells). Reed-Sternberg cells are specific to Hodgkin’s disease. They are not found in non-Hodgkin’s lymphoma.

HD usually starts in B cell lymphocytes located in lymph nodes in the neck area, although any lymph node may be the site of initial disease.

Click the icon to see an image of the lymph nodes in the head and neck.

Types of Hodgkin's Disease

There are two major types of Hodgkin’s disease: Classical Hodgkin’s lymphoma and nodular lymphocyte-predominant Hodgkin’s disease.

Classical Hodgkin's Lymphoma. Classical Hodgkin’s lymphoma accounts for about 95% of Hodgkin’s disease cases. It has four major subtypes:

• Nodular Sclerosis. Nodular sclerosis is the most common subtype, representing about 60 - 80% of HD cases. Younger patients are more likely to have this type. The nodes first affected are often those located in the center of the chest (the mediastinum) or the neck.
• Mixed Cellularity. Mixed cellularity is the next most common HD form, occurring in about 15 - 30% of patients, mostly in older adults. Mixed cellularity refers to the presence of Reed-Sternberg cells and other cell types.
• Lymphocyte Rich. The lymphocyte-rich subtype accounts for about 5% of all HD cases. It tends to affect men more than women.
• Lymphocyte Depleted. The lymphocyte-depleted subtype is the least common type of HD, occurring in only about 1% of cases. It is usually seen in older people and patients infected with HIV. It is also more common in less developed countries. The cancer tends to be diagnosed when it is widespread, affecting the spleen, bone marrow, and liver as well as abdominal lymph nodes.