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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.
Nodular Lymphocyte-Predominant Hodgkin's Disease. Nodular lymphocyte-predominant Hodgkin's disease occurs in about 5% of patients. It is distinct from classical Hodgkin’s lymphoma. The cells look like and are referred to as “popcorn” cells, which are variants of Reed-Sternberg cells. This type of HD typically affects younger patients and usually originates in the neck lymph nodes. It is sometimes confused with non-Hodgkin’s lymphoma (NHL). In fact, there is a 3 - 5% risk that nodular lymphocyte-predominant Hodgkin’s disease can transform into diffuse large B-cell NHL.
The Lymphatic System
Lymphomas are tumors of the lymphatic system. This system is a network of organs, ducts, and nodes. The lymphatic system transports a watery clear fluid called lymph throughout the body. The lymphatic system contains lymphocytes, which are important cells involved in defending the body against infections.
Lymphocytes. Lymphocytes, which are white blood cells, are a primary component of the immune system.
- Lymphocytes develop either in the bone marrow (called B cells or bone marrow-derived cells) or in the thymus gland (called T cells or thymus gland-derived cells).
- Both leukemia and lymphomas (Hodgkin’s disease and non-Hodgkin’s lymphomas) are cancers of lymphocytes. The difference is that leukemia starts in the bone marrow while lymphomas originate in lymph nodes and then spread to the bone marrow or other organs.
Lymphatic vessels. Lymphatic vessels begin as tiny tubes. These tubes collect and carry fluids that leak from body tissues, lymphocytes, proteins, and other substances collected from the body's tissues. The tubes lead to larger lymphatic ducts and branches, which drain into two ducts in the neck, where the fluid re-enters the bloodstream.
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Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
