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Lymphoma - Hodgkin's; Hodgkin's lymphoma; Hodgkins disease; HD
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.] Hodgkinâ ' s disease is also called Hodgkinâ ' s lymphoma.
Hodgkinâ ' 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 Hodgkinâ ' s disease. They are not found in non-Hodgkinâ ' s lymphoma.
Most often HD starts in B cell lymphocytes located in lymph nodes in the neck area, although any lymph node may be the site of initial disease.
There are two major types of Hodgkinâ ' s disease: Classical Hodgkinâ ' s lymphoma and nodular lymphocyte-predominant Hodgkinâ ' s disease.
Classical Hodgkin's Lymphoma. Classical Hodgkinâ ' s lymphoma accounts for about 95% of Hodgkinâ ' s disease cases. It has four major subtypes:
Nodular Lymphocyte-Predominant Hodgkin's Disease. Nodular lymphocyte-predominant Hodgkin's disease occurs in about 5% of patients. It is distinct from classical Hodgkinâ ' s lymphoma. The cells look like and are referred to as â€śpopcornâ€ť cells, which are variants of Reed-Sternberg cells. This type of HD typically affects younger patients and usually originates in the neck lymph nodesThis type of HD is sometimes confused with non-Hodgkinâ ' s lymphoma (NHL). In fact, there is a 3 - 5% risk that nodular lymphocyte-predominant Hodgkinâ ' s disease can transform into diffuse large B-cell NHL.
Lymphomas represent tumors of the lymphatic system. This system is a network of organs, ducts, and nodes. The system interacts with the blood's circulatory system to transport 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. This system also restores 60% of the fluid that leaks out from blood capillaries back into circulation. Its ducts provide transportation for fats, proteins, and other substances collected from the body's tissues.
Lymphocytes. The lymphatic system helps produce and transport lymphocytes, white blood cells that are a primary component of the immune system. Some lymphocytes produce antibodies that can target and attack specific foreign substances (antigens).
Lymph Nodes. In a lymph node, lymphocytes typically receive their initial exposure to foreign substances, such as bacteria. This exposure prompts the lymphocytes to perform their immune functions. The size of a lymph node varies generally from that of a pinhead to a bean. Most nodes are clustered throughout the body. Important node clusters are found in the neck, lower arm, armpit, and groin.
Other Structures in the Lymphatic System. The tonsils and adenoids are secondary lymphatic organs. They are composed of masses of lymph tissue that also play a role in the lymphatic system. The spleen is another important organ that processes lymphocytes from incoming blood.
Spread of Cancer. Hodgkin's disease usually progresses in an orderly way from one lymph node region to the next. This process may be slow, particularly in younger people, or very aggressive. The disease typically spreads downward from the initial site.
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