Pathogenesis, Pathological Features, and Distinguishing Characteristics of Hodgkin's and Non-Hodgkin's Lymphoma

Introduction

Lymphomas are cancers that originate in the lymphatic system, affecting lymphocytes, a type of white blood cell. They are broadly classified into Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), each with distinct pathological features and clinical presentations.

Pathogenesis

Hodgkin's Lymphoma

HL is characterized by the presence of Reed-Sternberg cells, which arise due to mutations in B lymphocytes. Epstein-Barr virus (EBV) infection is implicated in some cases, leading to uncontrolled cell proliferation.

Non-Hodgkin's Lymphoma

NHL comprises a heterogeneous group of lymphoid malignancies. The pathogenesis involves chromosomal translocations, such as t(14;18) in follicular lymphoma, leading to dysregulated cell growth.

Pathological Features

Histological Characteristics

HL presents with large binucleated Reed-Sternberg cells, surrounded by inflammatory cells. NHL demonstrates a wide range of histological patterns, including diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma.

Distinguishing Characteristics

• HL: Contiguous lymph node spread, presence of Reed-Sternberg cells, often associated with EBV.
• NHL: Non-contiguous spread, diverse histological subtypes, variable prognosis.

Clinical Presentation and Diagnostic Criteria for Hodgkin's Lymphoma

HL commonly presents with painless lymphadenopathy, night sweats, fever, and weight loss. Diagnosis involves:

• Histopathological examination of lymph node biopsy.
• Immunohistochemistry for CD15 and CD30.
• PET-CT for staging.

Conclusion

Hodgkin's and non-Hodgkin's lymphomas are distinct in terms of pathology and clinical behavior. Early diagnosis and appropriate treatment significantly impact patient outcomes.