Hodgkin’s lymphoma

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HODGKIN’S LYMPHOMA Most common lymph node affected – cervical lymph node. WHO classification ( 2 types on the basis of Reed Sternberg cells) A) CLASSICAL—(following 4 subtypes) ■ Best / most specific marker for RS cells —- PAX-5 (>90%…latest info) > CD 30 (80 to 100% of classical HL). Other markers CD 15 ( 75-85% ). 2) NODULAR SCLEROSIS. • Most common HL (world) • Mediastinal involvement most common in this HL. • Male and female are equally affected ( other HL, males are more commonly affected) • Lacunar reed Sternberg cells are seen (cytoplasmic lacuna formed due to tissue fixation artefact ) • “Collagen Bands” are forming nodules in Lymph nodes. 2) MIXED CELLULARITY • Most common HL in India • Maximum RS cells are seen. 3) LYMPHOCYTE DEPLETED. • Least common type of HL • RS cells (various names) —pleomorphic / Mummified / necrobiotic • Worst prognosis 4) LYMPHOCYTE RICH • Minimum RS cells are seen. B) LYMPHOCYTE PREDOMINANT • Popcorn RS cells (or lympho – histiocytic (L&H ) RS cells ) • Immunophenotyping- CD 20 (=BCL6+ve), CD 45, CD 79a, EMA (Epithelial Membrane Antigen) • Best prognosis amongst all HL. #HIGH yield info about HL:- • EBV and HIV infections ,both are most commonly a/w(amongst Hodgkins lymphoma subtype)—-MIXED CELLULARITY (HODGKINS LYMPHOMA) • HIV associated Hodgkins Lymphomas are —- mixed cellularity (most common) nodular sclerosis and lymphocyte depleted • EBV not associated with HL— 1) Nodular sclerosis 2) lymphocyte predominant
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